Medicine

Psychological Stress-Associated Ceramide and Diacylglyceride Lipotoxicity as Contributors to First Episode Depression Pathophysiology: A neuroimmune-Metabolic-Oxidative Stress (NIMETOX) Perspective

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This study examined lipid abnormalities in 88 university students with first-episode depression compared to healthy controls, using untargeted lipid profiling alongside measures of oxidative stress and psychological history. Researchers found that ceramides, diacylglycerides, and related lipid species were significantly elevated in depressed individuals, and these lipid alterations were strongly associated with prior adverse childhood experiences, negative life events, and markers of oxidative and nitrosative stress. Machine learning analysis showed that these lipid modules, combined with impaired reverse cholesterol transport and oxidative stress indicators, explained between 19% and 46% of the variance in depression severity, suicidal behaviors, insomnia, and anxiety symptoms.


If validated in larger peer-reviewed studies, specific plasma lipids such as ceramides and diacylglycerides could serve as early biological markers to identify individuals at risk for depression following psychosocial stress, potentially enabling earlier and more targeted interventions.


⚠️ Preprint – Noch nicht peer-reviewed

Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.

Background: Aberrations in neuro-immune, metabolic, and oxidative stress (NIMETOX) pathways are implicated in major depressive disorder (MDD). First-episode simple dysmood disorder (FE-SDMD) without metabolic syndrome offers a unique model to investigate early lipid alterations underlying NIMETOX pathophysiology. Methods: Plasma samples were collected from 88 university students (44 FE-SDMD, 44 healthy controls). Participants underwent comprehensive psychiatric and psychological assessments, including adverse childhood experiences (ACEs), negative life events (NLEs), depression, anxiety, suicidal behaviors, and insomnia. Untargeted lipid profiling was performed using LC-QTOF-MS, while indices of oxidative and nitrosative stress (ONS) and lecithin-cholesterol acyltransferase (LCAT) activity were assessed. Data was analyzed using machine learning approaches with recursive feature elimination and cross-validation. Results: FE-SDMD was characterized by increased ceramides (CER), diacylglycerides (DAG), triacylglycerides (TG), sphingomyelins (SM), bis-monoacylglycerol phosphates (BMP), cholestone, and fatty-acyl amino acids (FAAA). DAG, CER, and BMP were the strongest predictors of depression severity and physiosomatic symptoms, whereas cholestone, CER, and SM predicted suicidal behaviors. These lipid modules, together with lowered LCAT and increased ONS, explained substantial variance in depression severity (46.4%), physiosomatic symptoms (42.4%), cognitive-affective symptoms (37.9%), suicidal behaviors (30.1%), insomnia (32%), and anxiety (19.5%). ACEs and NLEs were strongly associated with CER (p<0.001), DAG (p<0.01), and cholestone (p<0.01). Conclusion: Early-stage MDD is characterized by distinct lipid dysregulations linked to psychosocial stress exposure, oxidative and nitrosative stress, and an indicant of impaired reverse cholesterol transport. These lipid modules may serve as early biomarkers and therapeutic targets in vulnerable populations.

Source: Psychological Stress-Associated Ceramide and Diacylglyceride Lipotoxicity as Contributors to First Episode Depression Pathophysiology: A neuroimmune-Metabolic-Oxidative Stress (NIMETOX) Perspective