Multiple reciprocal relationships between in vivo cellular immunity and hypothalamic-pituitary-adrenal axis in depression.
Major depression is reportedly characterized by increased activity of the hypothalamic-pituitary-adrenal (HPA) axis and by in vivo immune activation. The present study was carried out in order to investigate the relationships between HPA-axis activity and in vivo immune function in depression. Towards this end the following parameters were measured: 24 h urinary cortisol (UC) excretion; basal and post-dexamethasone (DST) plasma cortisol, beta-endorphin/beta-lipotropin (beta END/beta LPH) and dexamethasone concentrations; and leucocyte subsets (i.e. lymphocytes, neutrophils, monocytes, CD4+, CD4+CD45RA+, CD4+CD45RO+, CD8+, CD8+CD57+, CD8+CD57-, HLA-DR+, CD25+ T cells, HLA-DR+, CD19+, CD20+, and CD21+ B cells) both pre- and post-DST. Dexamethasone administration (1 mg orally) induced leucocytosis, lymphocytopaenia, monocytopaenia and neutrophilia. HPA-axis non-suppressors exhibited a relative resistance to the enhancing (e.g. neutrophils) or depressant (e.g. lymphocytes, CD4+ T cells) effects of dexamethasone. There were significant correlations between UC excretion and the number of percentage of lymphocytes, monocytes, CD4+CD45RA+ and CD8+CD57- T cells (negatively) and neutrophils (positively). It is concluded that multiple and complex intertwined relationships between HPA-axis hyperactivity and systemic immune stimulation participate in the pathophysiology or pathogenesis of major depression.
Maes
M
M
Department of Psychiatry, University Hospitals of Cleveland, Ohio 44106.
Meltzer
H Y
HY
Stevens
W
W
Cosyns
P
P
Blockx
P
P
D000328:Adult; D000367:Age Factors; D015703:Antigens, CD / Q000187:drug effects / Q000276:immunology; D003866:Depressive Disorder / Q000175:diagnosis / Q000276:immunology*; D003907:Dexamethasone / Q000097:blood / Q000494:pharmacology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine; D007030:Hypothalamo-Hypophyseal System / Q000276:immunology*; D007111:Immunity, Cellular / Q000276:immunology*; D007962:Leukocytes / Q000187:drug effects; D008297:Male; D010913:Pituitary-Adrenal System / Q000276:immunology*; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors
D015703:Antigens, CD; D003907:Dexamethasone; D006854:Hydrocortisone