title: Inflammation, depressive symptomtology, and coronary artery disease.
abstract: OBJECTIVE
  Many patients feel exhausted or depressed before the onset of an acute coronary event, but little is known about the origin of these feelings. We tested the hypothesis that the depressive symptomatology is associated with a reactivation of latent viruses and inflammation of a coronary vessel.
  
  
  METHODS
  A blood sample was drawn and a biopsy sample was obtained from the coronary lesion of 15 exhausted and 15 nonexhausted patients treated with directional coronary angioplasty because of severe angina. Blood samples were analyzed to measure antibody titers against Chlamydia pneumoniae, cytomegalovirus, and the cytokines interleukin (IL)-1beta, IL-6, and tumor necrosis factor (TNF)-alpha. The biopsy sample was analyzed for the presence of IL-1beta and TNF-alpha.
  
  
  RESULTS
  Exhausted/depressed patients had higher antibody titers against cytomegalovirus, higher levels of C. pneumoniae immunoglobulin G, and higher levels of IL-1beta and TNF-alpha. No associations between the mental state of a patient and cytokine mRNA in the biopsy sample were found.
  
  
  CONCLUSIONS
  The findings indicate that the mental state of angioplasty patients is positively associated with serological markers of inflammation. It remains to be seen whether the inflammation causes feelings of exhaustion, whether exhaustion and depression set the stage for inflammation, or whether existing feelings of exhaustion are amplified by the inflammation.
authors.affiliation: Department of Medical, Clinical, and Experimental Psychology, Maastricht University, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Appels
authors.forename: F W
authors.initials: FW
authors.lastname: Bär
authors.forename: J
authors.initials: J
authors.lastname: Bär
authors.forename: C
authors.initials: C
authors.lastname: Bruggeman
authors.forename: M
authors.initials: M
authors.lastname: de Baets
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology; D000328:Adult; D000368:Aged; D017130:Angioplasty; D003327:Coronary Disease / Q000276:immunology* / Q000628:therapy / Q000821:virology; D003586:Cytomegalovirus Infections / Q000276:immunology* / Q000503:physiopathology; D018076:DNA, Complementary / Q000276:immunology; D003865:Major Depressive Disorder / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007074:Immunoglobulin G / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology; D007378:Interleukins / Q000276:immunology; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011569:Psychiatric Status Rating Scales; D012333:RNA, Messenger / Q000276:immunology; D013315:Stress, Psychological / Q000276:immunology* / Q000503:physiopathology; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
chemical_list: D018076:DNA, Complementary; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007378:Interleukins; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha