title: Depressive symptoms in hip fracture patients are associated with reduced monocyte superoxide production.
abstract: Ageing is accompanied by reduced functioning of the immune system, termed immunesenescence which is associated with increased risk of infection and mortality. However the immune system does not operate in isolation and can be modified by many environmental factors, including stress. In this study we determined whether physical stress (hip fracture) and psychological distress (depressive symptoms) had additive effects upon the aged immune system, specifically on monocyte numbers and function. We assessed immune function in 101 hip fracture patients (81 female) 6weeks and 6months after injury and 43 healthy age matched controls (28 females). Thirty-eight of the hip fracture group were found to be depressed at the 6week sampling. No differences in peripheral monocyte count, distribution of monocyte subsets or TNFα secretion were observed between hip fracture patients and healthy controls. However we observed significantly reduced superoxide production in response to Escherichia coli in the monocytes of hip fracture patients who developed depressive symptoms compared with non-depressed hip fracture patients (p=0.002) or healthy controls (p=0.008) 6weeks after the fracture which remained decreased 6months following injury. In previous studies we have shown an effect of depression on neutrophil superoxide generation in hip fracture patients, suggesting a particular susceptibility of this aspect of immune cell function to psychological stress.
authors: School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK; MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham B15 2TT, UK.
authors: Niharika Arora
authors: NA
authors: Duggal
authors: School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK.
authors: Amy
authors: A
authors: Beswetherick
authors: MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham B15 2TT, UK; School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK.
authors: Jane
authors: J
authors: Upton
authors: School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK; MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham B15 2TT, UK.
authors: Peter
authors: P
authors: Hampson
authors: MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham B15 2TT, UK; School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK.
authors: Anna C
authors: AC
authors: Phillips
authors: School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK; MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham B15 2TT, UK. Electronic address: J.M.Lord@bham.ac.uk.
authors: Janet M
authors: JM
authors: Lord
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D018122:B7-1 Antigen / Q000378:metabolism; D051940:B7-2 Antigen / Q000378:metabolism; D016022:Case-Control Studies; D016207:Cytokines / Q000378:metabolism; D003687:Dehydroepiandrosterone / Q000378:metabolism; D003863:Depression / Q000378:metabolism*; D005260:Female; D006684:HLA-DR Antigens / Q000378:metabolism; D006620:Hip Fractures / Q000378:metabolism / Q000523:psychology*; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007963:Leukocytes, Mononuclear / Q000378:metabolism / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013315:Stress, Psychological / Q000378:metabolism; D013481:Superoxides / Q000378:metabolism*
chemical_list: D018122:B7-1 Antigen; D051940:B7-2 Antigen; D016207:Cytokines; D006684:HLA-DR Antigens; D013481:Superoxides; D003687:Dehydroepiandrosterone; D006854:Hydrocortisone
keywords: Ageing; Cortisol; Dehydroepiandrosterone; Depressive symptoms; Hip fracture; Monocyte function