title: Persistent systemic inflammation and symptoms of depression among patients with COPD in the ECLIPSE cohort.
abstract: BACKGROUND
  Depression is highly prevalent among patients with Chronic Obstructive Pulmonary Disease (COPD). The relationship of depression with systemic inflammation in COPD remains unknown. The objective of this observational study was to compare depression scores at baseline and after 36 months follow-up between COPD patients with persistent systemic inflammation (PSI) and never inflamed patients (NI) in the ECLIPSE cohort.
  
  
  METHODS
  The ECLIPSE study included 2164 COPD patients. Parameters assessed at baseline and at 36 months follow-up included: demographics, clinical characteristics and symptoms of depression (Center for Epidemiologic Studies of Depression, CES-D). Patients classified as NI had zero and patients with PSI had ≥2 inflammatory biomarkers (white blood cell count, hsCRP, IL-6, and fibrinogen) in the upper quartile, at baseline and 12 months later.
  
  
  RESULTS
  350 patients (29.1%) were NI and 131 patients (10.9%) had PSI. At baseline, mean CES-D score was higher in patients with PSI than in NI patients (11.7 (8.6) vs. 9.2 (8.9) points, p = 0.01). Differences were not confirmed after adjustment for possible confounders (β (95% CI) = 0.02 (-3.87 to 15.29), adjusted p = 0.98). At 36 months follow-up, CES-D scores were comparable in PSI and NI patients (12.2 (9.3) vs. 10.5 (9.0) points, p = 0.08) as were their temporal changes (0.5 (8.3) vs. 1.3 (7.9) points, p = 0.30).
  
  
  CONCLUSIONS
  The ECLIPSE study does not support a strong relationship between PSI and symptoms of depression at baseline and after 36 months follow-up in COPD.
  
  
  BACKGROUND
  The study was sponsored by GlaxoSmithKline.
authors.affiliation: Department of Research and Education, CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, Netherlands. Electronic address: daisyjanssen@ciro-horn.nl.
authors.forename: Daisy J A
authors.initials: DJ
authors.lastname: Janssen
authors.affiliation: Worldwide Epidemiology, GlaxoSmithKline, Uxbridge, United Kingdom. Electronic address: hana.x.muellerova@gsk.com.
authors.forename: Hana
authors.initials: H
authors.lastname: Müllerova
authors.affiliation: Thorax Institute, IDIBAPS, University of Barcelona, and FISIB, CIBER Enfermedades Respiratorias (CIBERES), Spain. Electronic address: AAGUSTI@clinic.ub.es.
authors.forename: Alvar
authors.initials: A
authors.lastname: Agusti
authors.affiliation: Research Triangle Park, GlaxoSmithKline, NC, United States. Electronic address: julie.c.yates@gsk.com.
authors.forename: Julie C
authors.initials: JC
authors.lastname: Yates
authors.affiliation: Respiratory Therapy Area Unit, GlaxoSmithKline, PA, United States. Electronic address: Ruth.M.Tal-Singer@gsk.com.
authors.forename: Ruth
authors.initials: R
authors.lastname: Tal-Singer
authors.affiliation: Pulmonary and Critical Care Medicine Section, University of Nebraska Medical Centre, NE, United States. Electronic address: srennard@unmc.edu.
authors.forename: Stephen I
authors.initials: SI
authors.lastname: Rennard
authors.affiliation: Department of Respiratory Medicine, Odense University Hospital and University of Southern Denmark, Odense, Denmark. Electronic address: jorgen.vestbo@manchester.ac.uk.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Vestbo
authors.affiliation: Department of Research and Education, CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, Netherlands; Respiratory Medicine, Maastricht UMC+, Maastricht, Netherlands. Electronic address: e.wouters@mumc.nl.
authors.forename: Emiel F M
authors.initials: EF
authors.lastname: Wouters
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D014481:United States / Q000453:epidemiology
chemical_list: D000928:Antidepressive Agents
keywords: Biomarkers; Chronic Obstructive Pulmonary Disease; Comorbidities; Depressive disorder; Psychological symptoms