title: Pretreatment levels of sTNF-R1 and sIL-6R are associated with a higher vulnerability for IFN-alpha-induced depressive symptoms in patients with malignant melanoma.
abstract: Immunomodulatory therapy with interferon-alpha (IFN-alpha) often leads to neuropsychiatric side effects, especially depression. An activation of the immune system is discussed to trigger neurotransmitter changes and depressive illness. So far, few data are available about biologic markers, who may predict the individual risk for developing depressive symptoms during IFN-alpha therapy. The aim of the present study was to investigate the predictive role of certain immunologic markers for the development of IFN-alpha-induced depression. We hypothesized that patients characterized by a proinflammatory and TH1-accentuated immune response before treatment might have an increased risk for developing depressive mood changes. Thirty-three melanoma patients were prospectively investigated during adjuvant treatment with IFN-alpha-2a/2b (3 x 3 Mio units/wk). Depressive mood changes were assessed with the self-rating depression scale (SDS, Zung-scale) before and during IFN-alpha treatment. Serum concentrations of soluble tumor necrosis factor-R1 (sTNF-R1), soluble interleukin-6R (sIL-6R), sIL-4R, and neopterin were measured before and after 3 months of treatment. sIL-6R, which was negatively associated with SDS scores, significantly predicted higher depression scores in the first 3 months of IFN-alpha treatment. sTNF-R1, which was positively associated with SDS scores, significantly predicted the development of late depressive symptoms after 6 months of therapy. In contrast to the initial hypothesis, patients characterized by high sTNF-R1 and low sIL-6R baseline levels, indicating an anti-inflammatory condition before therapy, had a higher vulnerability for depression during IFN-alpha therapy.
authors.affiliation: Department of Psychiatry, Charité, Campus Mitte, Berlin, Germany.
authors.forename: Astrid
authors.initials: A
authors.lastname: Friebe
authors.forename: Markus J
authors.initials: MJ
authors.lastname: Schwarz
authors.forename: Monika
authors.initials: M
authors.lastname: Schmid-Wendtner
authors.forename: Matthias
authors.initials: M
authors.lastname: Volkenandt
authors.forename: Folkhart
authors.initials: F
authors.lastname: Schmidt
authors.forename: Martin
authors.initials: M
authors.lastname: Horn
authors.forename: Gesa
authors.initials: G
authors.lastname: Janssen
authors.forename: Martin
authors.initials: M
authors.lastname: Schaefer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D003863:Depression / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D053662:Interleukin-4 Receptor alpha Subunit / Q000097:blood; D008545:Melanoma / Q000188:drug therapy*; D008875:Middle Aged; D019798:Neopterin / Q000097:blood; D011379:Prognosis; D019947:Receptors, Interleukin-6 / Q000097:blood*; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood*; D011994:Recombinant Proteins; D012878:Skin Neoplasms / Q000188:drug therapy*; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; C504000:IL4R protein, human; C508603:IL6R protein, human; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D053662:Interleukin-4 Receptor alpha Subunit; D019947:Receptors, Interleukin-6; D047888:Receptors, Tumor Necrosis Factor, Type I; D011994:Recombinant Proteins; D019798:Neopterin