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Seishin Igaku Volume 44, Issue 1 （January 2002）

精神医学 44巻1号（2002年1月発行）

Japanese English

研究と報告

全般性不安障害にみられる高bradykinin血症について Hyperbradykininemina in Generalized Anxiety Disorder 福田克彦 ¹ , 高橋良当 ¹ , 山中学 ¹ , 渡辺尚彦 ¹ , 大川真一郎 ¹ Katsuhiko FUKUDA ¹ , Yoshiatsu TAKAHASHI ¹ , Gaku YAMANAKA ¹ , Yoshihiko WATANABE ¹ , Shin-ichiro OHKAWA ¹ ¹東京女子医科大学附属第二病院内科 ¹Department of Medicine, Tokyo Women's Medical University Daini Hospital キーワード： Bradykinin , Hamilton Anxiety Rating Scale , Generalized anxiety disorder Keyword: Bradykinin , Hamilton Anxiety Rating Scale , Generalized anxiety disorder pp.63-68

発行日 2002年1月15日 Published Date 2002/1/15

DOI https://doi.org/10.11477/mf.1405902566

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Abstract 文献概要
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【抄録】　不安神経症の，息苦しさ，窒息感がbradykinin（BK）と関連する可能性を調べた。対象は，全般性不安障害11名で，BKを測定し不安をHamilton Anxiety Rating Scale（HAM-A）で計測した。結果は，BK値が100.1pg/ml（SD 44.6）と高値を示し，HAM-AとBK値は有意な正の相関が得られ，回帰方程式はBK＝5.10(HAM-A)－51.5，r＝0.62，p＜0.05で与えられた。BKは侵害受容伝達，全身性の細動脈弛緩と水・C1利尿による血圧低下，catecholaminesの遊離，細静脈血管透過性の亢進による浮腫，内臓平滑筋収縮などの作用があり，不安神経症の身体症状が，BKの類炎症作用から惹起される可能性が考えられた。

Objective: Hyperbradykininemia was reported in case of angioedema and dry cough as an adverse effect of angiotensin-converting-enzyme (ACE) inhibitors. There is a possibility that the choking sensation, shortness of breath, or smothering sensation in anxiety neurosis could he induced by bradykinin (BK). We sought to examine plasma-BK concentrations of Generalized Anxiety Disorder (GAD) and postulated a new concept of anxiety disorders.

Method: We identified 11 GAD patients. We measured inflammatory markers (WBC, ESR, CRP). Cl-inhibitor activity and circulating BK using a newly developed radioimmunoassay technique. Anxiety was measured using the Hamilton Anxiety Rating Scale (HAM-A).

Results: No abnormalities were found in WBC, ESR, CRP and Cl-inhibitor activity. There were substantial rises in BK in GAD with a mean plasma-BK concentration of 100.1 pg/ml (SD=44.6). There was a significant correlation between HAM-A and plasma-BK concentration in the 11 GAD patients, expressed by the regression: BK=5.10 (HAM-A) -51.5, r=0.62, p＜0.05. There was no significant correlation between Cl-inhibitor activity and plasma-BK concentration.

Discussion: The fact that there was no-significant correlation between Cl-inhibitor activity and plasma-BK concentration demonstrates the difference from laryngeal edema in patients with hereditary angioedema. The symptoms of anxiety could be explained by the nature of BK which acts to produce pain, vasodilation, increased vascular permeability, and synthesis of prostaglandins. Therefore, GAD may be termed a diffuse nociceptive state, or an incomplete inflammatory state tmcoupling from other inflammatory markers.