title: Unmedicated, remitted patients with major depression have decreased serum immunoglobulin A.
abstract: Patents with major depression have evidence of a proinflammatory state with consistent elevations in acute phase proteins and in the levels of inflammatory mediators such as interleukin-6 and tumor necrosis factor-α. We report here a study of the serum levels of immunoglobulin A (IgA) in medication-free patients with major depression in the remitted state (ruMDD). Selective IgA deficiency is the most common form of immunoglobulin abnormality, and is often associated with a higher than expected incidence of proinflammatory and autoimmune phenomena. We measured serum IgG, IgM, and IgA in 28 ruMDD patients and 27 healthy subjects (Ctrl) at 0 (pretreatment), 7, and 24h following sham depletion and tryptophan (TrpD) depletion conducted at least 8 days apart under balanced, randomized, blinded conditions. Immunoglobulins were measured by automated immunonephelometry. Data were analyzed by repeated measures ANOVA with diagnosis as a fixed effect and drug (TrpD vs. sham), and time as repeated measures factors. Serum IgA was consistently lower in ruMDD patients vs. Ctrl at all time points examined (p<0.04 for main effect of diagnosis). Serum IgG and IgM levels did not show significant differences by diagnosis. Medication-free patients with major depression in the remitted state have a significant reduction in serum IgA levels measured on multiple occasions. In the light of the fact that IgA serves many immunomodulatory, anti-inflammatory roles, this finding supports the concept that major depressive illness represents a proinflammatory state.
authors.affiliation: Clinical Neuroendocrinology Branch, NIH/NIMH, 10 Center Drive, Bethesda, MD 20892, USA.
authors.forename: Philip W
authors.initials: PW
authors.lastname: Gold
authors.affiliation: Clinical Neuroendocrinology Branch, NIH/NIMH, 10 Center Drive, Bethesda, MD 20892, USA.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Pavlatou
authors.affiliation: Department of Psychiatry, University of Utah, School of Medicine and Salt Lake VA Medical Center, 50 North Medical Drive, Salt Lake City, UT 84132, USA.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Carlson
authors.affiliation: Experimental Therapeutics and Pathophysiology Branch, NIH/NIMH, 10 Center Drive, Bethesda, MD 20892, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Luckenbaugh
authors.affiliation: Department of Laboratory Medicine, NIH Clinical Center, 10 Center Drive, Bethesda, MD 20892, USA.
authors.forename: Rene
authors.initials: R
authors.lastname: Costello
authors.affiliation: Department of Psychiatry, Hadassah-Hebrew-University Medical Center, Jerusalem 91120, Israel.
authors.forename: Omer
authors.initials: O
authors.lastname: Bonne
authors.affiliation: Department of Laboratory Medicine, NIH Clinical Center, 10 Center Drive, Bethesda, MD 20892, USA.
authors.forename: Gyorgy
authors.initials: G
authors.lastname: Csako
authors.affiliation: Laureate Institute for Brain Research, 6655 S. Yale Avenue, Tulsa, OK 74136, USA.
authors.forename: Wayne C
authors.initials: WC
authors.lastname: Drevets
authors.affiliation: Department of Laboratory Medicine, NIH Clinical Center, 10 Center Drive, Bethesda, MD 20892, USA.
authors.forename: Alan T
authors.initials: AT
authors.lastname: Remaley
authors.affiliation: Office of the Dean, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA.
authors.forename: Dennis S
authors.initials: DS
authors.lastname: Charney
authors.affiliation: Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Neumeister
authors.affiliation: Clinical Neuroendocrinology Branch, NIH/NIMH, 10 Center Drive, Bethesda, MD 20892, USA; Behavioral Health Service, Philadelphia VA Medical Center, Philadelphia, PA, USA; Department of Psychiatry, University of Pennsylvania School of Medicine, 3615 Chestnut Street, Philadelphia, PA 19104, USA.
authors.forename: Mitchel A
authors.initials: MA
authors.lastname: Kling
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D003865:Major Depressive Disorder / Q000097:blood / Q000188:drug therapy / Q000276:immunology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male
chemical_list: D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M