title: Immune-endocrine host response to endotoxin in major depression.
abstract: OBJECTIVE
  An impaired hypothalamic-pituitary-adrenocortical (HPA) function is a well-established finding in major depression (MD), but it is still unclear how this dysfunction affects immune responses in this disorder.
  
  
  METHODS
  To further examine the relationship between immune and endocrine responses in MD, 0.4ng/kg body weight endotoxin [LPS] or 100mug hCRH were sequentially applied to 12 patients with MD and to 12 age- and gender-matched healthy controls after pre-treatment with 1.5mg dexamethasone (DEX). Immune (TNF-alpha, IL-6, rectal temperature) and endocrine (ACTH, cortisol) parameters were examined as area under the curve (AUC) levels.
  
  
  RESULTS
  After pre-treatment with DEX, LPS evoked an immune response in all participants of the study with most immune parameters significantly related to the endotoxin challenge. However, only a marked immune response resulted in an additional endocrine reaction. Subsequently, the quantitative extent of the endocrine reaction was related to the extent of the immune response after DEX/LPS challenge. Pre-LPS AUC levels of cortisol, ACTH and post-LPS levels of IL-6 as well as the post-CRH AUC levels of cortisol and ACTH were related to the depressive symptomatology as measured by the Beck depression inventory (BDI). In depressive patients who showed increased cortisol plasma levels before LPS, the later increase in IL-6 was reduced.
  
  
  CONCLUSIONS
  The challenge with DEX/LPS did not reveal major impairments of evoked immune functions in MD. Only the endocrine parameters and the IL-6 response were related to the depressive symptomatology, suggesting a limited interaction between immune and endocrine dysfunctions in MD.
authors.affiliation: Max Planck Institute of Psychiatry, Munich, Germany. vedder@med.uni-marburg.de
authors.forename: Helmut
authors.initials: H
authors.lastname: Vedder
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schreiber
authors.forename: Andreas
authors.initials: A
authors.lastname: Schuld
authors.forename: Martin
authors.initials: M
authors.lastname: Kainz
authors.forename: Christoph Johannes
authors.initials: CJ
authors.lastname: Lauer
authors.forename: Jürgen-Christian
authors.initials: JC
authors.lastname: Krieg
authors.forename: Florian
authors.initials: F
authors.lastname: Holsboer
authors.forename: Thomas
authors.initials: T
authors.lastname: Pollmächer
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000704:Analysis of Variance; D019540:Area Under Curve; D001831:Body Temperature / Q000276:immunology; D016022:Case-Control Studies; D003346:Corticotropin-Releasing Hormone / Q000008:administration & dosage; D003865:Major Depressive Disorder / Q000097:blood / Q000276:immunology / Q000503:physiopathology*; D003907:Dexamethasone / Q000008:administration & dosage; D004703:Endocrine System / Q000187:drug effects / Q000503:physiopathology*; D004731:Endotoxins / Q000008:administration & dosage* / Q000276:immunology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007109:Immunity / Q000502:physiology*; D015850:Interleukin-6 / Q000097:blood; D008070:Lipopolysaccharides / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D004731:Endotoxins; D015850:Interleukin-6; D008070:Lipopolysaccharides; D014409:Tumor Necrosis Factor-alpha; D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone