title: Sustained low-grade pro-inflammatory state in unmedicated, remitted women with major depressive disorder as evidenced by elevated serum levels of the acute phase proteins C-reactive protein and serum amyloid A.
abstract: BACKGROUND
  Major depressive disorder (MDD) shows increased coronary artery disease (CAD) risk of unknown mechanism(s). MDD is more common in women than men; CAD diagnosis can be difficult in women. Elevations of the inflammatory markers C-reactive protein (CRP) and serum amyloid A (SAA) predict increased CAD risk in populations; few data on these markers exist in MDD, particularly in remitted patients.
  
  
  METHODS
  We measured fasting am serum CRP (high sensitivity, CRP(hs)) and SAA in 18 unmedicated, remitted women with MDD (mean age 41 +/- (SD)12, body mass index (BMI) 25.2 +/- 4.1 kg/m(2)) and 18 BMI-matched healthy control subjects (age 36 +/- 10, BMI 25.3 +/- 3.8 kg/m(2)) on 2 separate occasions, > or = 6 days apart.
  
  
  RESULTS
  Repeat SAA and CRP(hs) measurements strongly correlated across study days (SAA: r = .83, p < .001; CRP(hs): r = .94, p < .001). Both SAA (5.30 +/- 3.39 vs. 2.84 +/- 1.87 mg/L, p < .005) and CRP(hs) (3.23 +/- 3.17 vs. 1.12 +/- 1.45 mg/L; p < .01) were significantly elevated in MDD women versus controls.
  
  
  CONCLUSIONS
  Elevated SAA and CRP(hs) in remitted, unmedicated women with MDD indicate a pro-inflammatory state unrelated to current depressive symptoms or pharmacotherapy. These findings suggest that inflammatory mechanisms may in part underlie findings of increased CAD risk in MDD.
authors.affiliation: Clinical Neuroendocrinology Branch, Division of Intramural Research Programs, National Institute of Mental Health, Bethesda, MD 20892-1284, USA. klingm@mail.nih.gov
authors.forename: Mitchel A
authors.initials: MA
authors.lastname: Kling
authors.forename: Salvatore
authors.initials: S
authors.lastname: Alesci
authors.forename: Gyorgy
authors.initials: G
authors.lastname: Csako
authors.forename: Rene
authors.initials: R
authors.lastname: Costello
authors.forename: David A
authors.initials: DA
authors.lastname: Luckenbaugh
authors.forename: Omer
authors.initials: O
authors.lastname: Bonne
authors.forename: Roman
authors.initials: R
authors.lastname: Duncko
authors.forename: Wayne C
authors.initials: WC
authors.lastname: Drevets
authors.forename: Husseini K
authors.initials: HK
authors.lastname: Manji
authors.forename: Dennis S
authors.initials: DS
authors.lastname: Charney
authors.forename: Philip W
authors.initials: PW
authors.lastname: Gold
authors.forename: Alexander
authors.initials: A
authors.lastname: Neumeister
mesh_terms: D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood / Q000523:psychology; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000097:blood / Q000276:immunology*; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D016555:Matched-Pair Analysis; D008875:Middle Aged; D012016:Reference Values; D012307:Risk Factors; D000685:Serum Amyloid A Protein / Q000032:analysis*; D018709:Statistics, Nonparametric
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein