title: Increased serum tumor necrosis factor-alpha levels and treatment response in major depressive disorder.
abstract: BACKGROUND
  Over the last 15 years, an increasing body of evidence has suggested a causal relationship between depression and the immunological activation and hypersecretion of pro-inflammatory cytokines, such as interleukin-1, interleukin-6 and tumor necrosis factor-alpha (TNF-alpha). However, little is known about the probable relationship of serum TNF-alpha with major depressive disorder (MDD).
  
  
  OBJECTIVE
  To assess whether serum TNF-alpha levels could be associated with the clinical course of MDD.
  
  
  METHODS
  TNF-alpha and C-reactive protein (CRP) serum concentrations, erythrocyte sedimentation rate, and leukocyte count were measured in 26 MDD patients and in 17 controls. The measurements were repeated following 6 weeks of antidepressant treatment with selective serotonin re-uptake inhibitors. Psychopathological improvement and the severity of depression were evaluated with the Hamilton Depression Rating Scale (HAMD) and Beck Depression Inventory (BDI).
  
  
  RESULTS
  On admission, serum TNF-alpha and leukocyte count were significantly higher in MDD patients compared to controls ( P<0.001 and P=0.005, respectively). With the antidepressant treatment, both HAMD and BDI scores decreased significantly (P<0.001 for both). Comparison of pre- and post-treatment measurements revealed that TNF-alpha, CRP, and leukocyte count decreased to levels comparable with those of the control subjects ( P<0.001, P=0.01, and P=0.01, respectively).
  
  
  CONCLUSIONS
  The results emphasized that some immunological parameters, such as CRP, leukocyte count and TNF-alpha, are significantly involved in the clinical course and treatment response in MDD. TNF-alpha in particular could be considered as a potential state marker in MDD.
authors.affiliation: Department of Psychiatry, Trakya University School of Medicine, 22030 Edirne, Turkey. ctuglu@hotmail.com
authors.forename: Cengiz
authors.initials: C
authors.lastname: Tuglu
authors.forename: S Hakan
authors.initials: SH
authors.lastname: Kara
authors.forename: Okan
authors.initials: O
authors.lastname: Caliyurt
authors.forename: Erdal
authors.initials: E
authors.lastname: Vardar
authors.forename: Ercan
authors.initials: E
authors.lastname: Abay
mesh_terms: D000328:Adult; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D003866:Depressive Disorder / Q000097:blood* / Q000145:classification / Q000188:drug therapy; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D002097:C-Reactive Protein; D017367:Selective Serotonin Reuptake Inhibitors; D014409:Tumor Necrosis Factor-alpha