title: Effect of selective serotonin reuptake inhibitors and immunomodulator on cytokines levels: an alternative therapy for patients with major depressive disorder.
abstract: Major depressive disorder (MDD) is a psychiatric illness that presents as a deficit of serotonergic neurotransmission in the central nervous system. MDD patients also experience alterations in cortisol and cytokines levels. Treatment with selective serotonin reuptake inhibitors (SSRIs) is the first-line antidepressant regimen for MDD. The aim of this study was to determine the effect of a combination of SSRIs and an immunomodulator-human dialyzable leukocyte extract (hDLE)-on cortisol and cytokines levels. Patients received SSRIs or SSRIs plus hDLE. The proinflammatory cytokines IL-1 β , IL-2, and IFN- γ ; anti-inflammatory cytokines IL-13 and IL-10; and 24-h urine cortisol were measured at weeks (W) 0, 5, 20, 36, and 52 of treatment. The reduction in cortisol levels in the SSRI-treated group was 30% until W52, in contrast, the combined treatment induced a 54% decrease at W36. The decline in cortisol in patients who were treated with SSRI plus hDLE correlated with reduction of anti-inflammatory cytokines and increases levels of proinflammatory cytokines at the study conclusion. These results suggest that the immune-stimulating activity of hDLE, in combination with SSRIs, restored the pro- and anti-inflammatory cytokine balance and cortisol levels in depressed patients versus those who were given SSRIs alone.
authors.affiliation: Department of Psychoimmunology, National Institute of Psychiatry "Ramón de la Fuente", Calzada México-Xochimilco 101, Col. San Lorenzo Huipulco, Tlalpan, 14370 Mexico City, DF, Mexico ; Universidad Autónoma Metropolitana. Avenida San Rafael Atlixco No. 186, Col. Vicentina, Iztapalapa, 09340 Mexico City, DF, Mexico.
authors.forename: María Eugenia
authors.initials: ME
authors.lastname: Hernandez
authors.affiliation: National Institute of Psychiatry "Ramón de la Fuente", Calzada México-Xochimilco 101, Col. San Lorenzo Huipulco, Tlalpan, 14370 Mexico City, DF, Mexico.
authors.forename: Danelia
authors.initials: D
authors.lastname: Mendieta
authors.affiliation: Department of Immunology, National School of Biological Sciences (ENCB), National Polytechnic Institute (IPN), 11340 Mexico City, DF, Mexico.
authors.forename: Mayra
authors.initials: M
authors.lastname: Pérez-Tapia
authors.affiliation: Departamento de Inmunología, Instituto Nacional de Cardiología, 14080 Mexico City, DF, Mexico.
authors.forename: Rafael
authors.initials: R
authors.lastname: Bojalil
authors.affiliation: Department of Immunology, National School of Biological Sciences (ENCB), National Polytechnic Institute (IPN), 11340 Mexico City, DF, Mexico.
authors.forename: Iris
authors.initials: I
authors.lastname: Estrada-Garcia
authors.affiliation: Department of Immunology, National School of Biological Sciences (ENCB), National Polytechnic Institute (IPN), 11340 Mexico City, DF, Mexico.
authors.forename: Sergio
authors.initials: S
authors.lastname: Estrada-Parra
authors.affiliation: Department of Psychoimmunology, National Institute of Psychiatry "Ramón de la Fuente", Calzada México-Xochimilco 101, Col. San Lorenzo Huipulco, Tlalpan, 14370 Mexico City, DF, Mexico.
authors.forename: Lenin
authors.initials: L
authors.lastname: Pavón
mesh_terms: D000328:Adult; D016207:Cytokines / Q000097:blood / Q000378:metabolism*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000378:metabolism*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism / Q000652:urine; D007155:Immunologic Factors / Q000008:administration & dosage / Q000627:therapeutic use*; D018836:Inflammation Mediators / Q000097:blood / Q000378:metabolism; D008297:Male; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D016207:Cytokines; D006854:Hydrocortisone; D007155:Immunologic Factors; D018836:Inflammation Mediators; D017367:Selective Serotonin Reuptake Inhibitors