Cytokine production and treatment response in major depressive disorder.
In a controlled study, such immunological parameters as whole blood production of the cytokines interleukin-6 (IL-6) and tumor-necrosis factor-alpha (TNF-alpha) were assessed in 24 inpatients with a major depressive disorder (MDD) both before and again under treatment. After a 6-week treatment period with amitriptyline, patients were classified as responders or nonresponders according to their psychopathological outcome as evaluated by the Hamilton and the Montgomery-Asberg Depression Rating Scales. Pre-treatment levels of c-reactive protein (CRP) were significantly higher in both patient subgroups than in the control subjects. In comparison to the controls, unstimulated pretreatment production of IL-6 was significantly decreased in the responders; whereas it was significantly increased in the nonresponder subgroup. Post-treatment values did not differ significantly among the patient and control groups. Pretreatment levels of TNF-alpha were increased in both patient subgroups, with a significant decrease during treatment only in the responder subgroup. Pretreatment levels of IL-6/10(5) mononuclear cells and the ratio between lymphocytes and monocytes acted as independent variables with regard to the clinical response. Our data indicate that unstimulated secretion of TNF-alpha is related to the psychopathological improvement; whereas, IL-6 levels might dichotomize the patients into subsequent responders and nonresponders already at admission.
Lanquillon
S
S
Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Marburg, Germany.
Krieg
J C
JC
Bening-Abu-Shach
U
U
Vedder
H
H
D000639:Amitriptyline / Q000008:administration & dosage; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage; D002452:Cell Count; D016207:Cytokines / Q000096:biosynthesis / Q000097:blood*; D003866:Depressive Disorder / Q000097:blood* / Q000523:psychology; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D018655:Lymphocyte Count / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000187:drug effects; D012044:Regression Analysis; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D000929:Antidepressive Agents, Tricyclic; D016207:Cytokines; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D000639:Amitriptyline