title: Major depressive disorder and immunity to varicella-zoster virus in the elderly.
abstract: Major depressive disorder has been associated with activation of inflammatory processes as well as with reductions in innate, adaptive and non-specific immune responses. The objective of this study was to evaluate the association between major depression and a disease-relevant immunologic response, namely varicella-zoster virus (VZV)-specific immunity, in elderly adults. A cross-sectional cohort study was conducted in 104 elderly community dwelling adults ≥ 60years of age who were enrolled in the depression substudy of the shingles prevention study, a double blind, placebo-controlled vaccine efficacy trial. Fifty-two subjects had a current major depressive disorder, and 52 age- and sex-matched controls had no history of depression or any mental illness. VZV-specific cell-mediated immunity (VZV-CMI) was measured by VZV responder cell frequency (VZV-RCF) and interferon-γ enzyme-linked immunospot (ELISPOT) assays, and antibody to VZV was measured by an enzyme-linked immunosorbent assay against affinity-purified VZV glycoproteins (gpELISA). VZV-CMI, measured by VZV-RCF, was significantly lower in the depressed group than in the controls (p<0.001), and VZV-RCF was inversely correlated with the severity of depressive symptoms in the depressed patients. In addition, an age-related reduction in VZV-RCF was observed in the depressed patients, but not in the controls. Furthermore, there was a trend for depressive symptom severity to be associated with lower ELISPOT counts. Finally, VZV-RCF was higher in depressed patients treated with antidepressant medications as compared to untreated depressed patients. Since lower levels of VZV-RCF appear to explain the increased risk and severity of herpes zoster observed in older adults, these findings suggest that, in addition to increasing age, depression may increase the risk and severity of herpes zoster.
authors.affiliation: Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90095-7057, USA. Mirwin1@ucla.edu
authors.forename: Michael R
authors.initials: MR
authors.lastname: Irwin
authors.forename: Myron J
authors.initials: MJ
authors.lastname: Levin
authors.forename: Carmen
authors.initials: C
authors.lastname: Carrillo
authors.forename: Richard
authors.initials: R
authors.lastname: Olmstead
authors.forename: Anne
authors.initials: A
authors.lastname: Lucko
authors.forename: Nancy
authors.initials: N
authors.lastname: Lang
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Caulfield
authors.forename: Adriana
authors.initials: A
authors.lastname: Weinberg
authors.forename: Ivan S F
authors.initials: IS
authors.lastname: Chan
authors.forename: Jim
authors.initials: J
authors.lastname: Clair
authors.forename: Jeff G
authors.initials: JG
authors.lastname: Smith
authors.forename: R D
authors.initials: RD
authors.lastname: Marchese
authors.forename: Heather M
authors.initials: HM
authors.lastname: Williams
authors.forename: Danielle J
authors.initials: DJ
authors.lastname: Beck
authors.forename: Patricia T
authors.initials: PT
authors.lastname: McCook
authors.forename: Gary
authors.initials: G
authors.lastname: Johnson
authors.forename: Michael N
authors.initials: MN
authors.lastname: Oxman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood / Q000276:immunology*; D000704:Analysis of Variance; D000914:Antibodies, Viral / Q000097:blood; D000928:Antidepressive Agents / Q000276:immunology* / Q000627:therapeutic use; D016022:Case-Control Studies; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000097:blood / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D006562:Herpes Zoster / Q000276:immunology* / Q000523:psychology; D014645:Herpesvirus 3, Human / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects / Q000276:immunology*; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D012016:Reference Values; D012307:Risk Factors
chemical_list: D000914:Antibodies, Viral; D000928:Antidepressive Agents