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Roske C, Nguyen TN, Schwartz JJ, Erulker A, Nie K, Xie H, Kim-Schulze S, Ely BA, Tobe RH, Mowrey W, Gabbay V. Immunological correlates of suicidality among adolescents with internalizing symptoms. Brain Behav Immun Health 2024; 41:100866. [PMID: 39350953 PMCID: PMC11439560 DOI: 10.1016/j.bbih.2024.100866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 08/14/2024] [Accepted: 09/16/2024] [Indexed: 10/04/2024] Open
Abstract
Background Suicide is a leading cause of death in adolescents and young adults globally. Well-established risk factors for suicide are depression and past suicide attempts. People experiencing suicidality may represent a distinct neurobiological group of people with depression. Because converging evidence has implicated inflammation in depression, we sought to investigate relationships between suicidality and immune markers in youth experiencing diverse mood and anxiety symptoms. We hypothesized that adolescents with suicidality would exhibit a unique immune signature. Methods Adolescents underwent semi-structured interviews and completed self-reported measures to assess psychopathology, including suicidality (suicidal ideation, plans, or attempts). Fasting blood samples were collected, cultured with and without lipopolysaccharide (LPS) to stimulate an inflammatory response, and analyzed for 41 immune analytes. To assess how immune function related to suicidality categorically and dimensionally, we conducted group comparisons and correlations while controlling for multiple comparisons using false discovery rate (FDR). To further uncover subtle immune-suicidality relationships, we employed a data-driven approach using factor analysis to extract major immune factors, each of which was subsequently correlated with suicidality measures. Results Among 126 participants, 29 were healthy controls and 97 participants had internalizing symptoms; within the clinical group, 57 experienced suicidality. Three immune analytes differed between healthy controls, suicidal, and non-suicidal adolescents with internalizing symptoms in the LPS condition: Flt-3L (p FDR = 0.0246), GM-CSF (p FDR = 0.0246), and IFN-γ (p FDR = 0.0246). These analytes were negatively correlated with the Beck Scale for Suicide Ideation (BSSI): Flt-3L (ρ = -0.19, p = 0.04); GM-CSF (ρ = -0.26, p = 0.004); IFN-γ (ρ =-0.33, p = 0.0003). GM-CSF also negatively correlated with number of suicide attempts (ρ = -0.39, p = 0.003). Factor analysis reduced 41 analytes to several common immune factors across experimental conditions, with Flt-3L, GM-CSF, and IFN-γ all loading heavily onto immune factors that were hypoactive in suicidality. Through this data-driven approach, we detected further associations between suicidality and immune factors across all conditions. Conclusions Peripheral immune function may be distinctly altered in adolescent suicidality. Future work should examine immune-suicidality relationships longitudinally.
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Affiliation(s)
- Chloe Roske
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Tram N.B. Nguyen
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
- Medical Scientist Training Program, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Joshua J. Schwartz
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ava Erulker
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Kai Nie
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hui Xie
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Seunghee Kim-Schulze
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Benjamin A. Ely
- Department of Psychiatry and Behavioral Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Russell H. Tobe
- Department of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
- Center for the Developing Brain, Child Mind Institute, New York, NY, USA
| | - Wenzhu Mowrey
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Vilma Gabbay
- Department of Psychiatry and Behavioral Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
- Department of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
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Yang S, Han J, Ye Z, Zhou H, Yan Y, Han D, Chen S, Wang L, Feng Q, Zhao X, Kang C. The correlation of inflammation, tryptophan-kynurenine pathway, and suicide risk in adolescent depression. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02579-4. [PMID: 39287643 DOI: 10.1007/s00787-024-02579-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 09/02/2024] [Indexed: 09/19/2024]
Abstract
Accumulating evidence suggests a role for the tryptophan-kynurenine pathway (TKP) in the psychopathology of major depressive disorder (MDD). Abnormal inflammatory profile and production of TKP neurotoxic metabolites appear more pronounced in MDD with suicidality. Progress in understanding the neurobiology of MDD in adolescents lags significantly behind that in adults due to limited empirical evidence. Aims of this study was to investigate the association between inflammation, TKP, and suicidality in adolescent depression. Seventy-three adolescents with MDD were assessed for serum levels of interleukin (IL)-1β, IL-6, IL-18, IL-10, tumor necrosis factor-α (TNF-α), tryptophan (TRP), kynurenine (KYN), 3-hydroxykynurenine (3-HK), and kynurenine acid (KA). Correlations between cytokines and TKP measures were examined. Patients were divided into high- (n = 42) and non-high-suicide-risk groups (n = 31), and serum levels of cytokines and TKP metabolites were compared. Significant negative correlations were found between TRP and IL-8 (r = - 0.27, P < 0.05) and IL-10 (r = - 0.23, P < 0.05), while a significant positive correlation was observed between 3-HK and IL-8 (r = 0.39, P < 0.01) in depressed adolescents. The KYN/TPR (index of indoleamine 2,3-dioxygenase, IDO) was positively correlated with IL-1β (r = 0.34), IL-6 (r = 0.32), IL-10 (r = 0.38) and TNF-α (r = 0.35) levels (P < 0.01); and 3-HK/KYN (index of kynurenine3-monooxidase, KMO) was positively correlated with IL-8 level (r = 0.31, P < 0.01). Depressed adolescents at high suicide risk exhibited significantly higher levels of IL-1β (Z = 2.726, P < 0.05), IL-10 (Z = 2.444, P < 0.05), and TNF-α (Z = 2.167, P < 0.05) and lower levels of 3-HK (Z = 2.126, P < 0.05) compared to their non-high suicide risk counterparts. Our findings indicated that serum inflammatory cytokines were robustly associated with IDO and KMO activity, along with significantly decreased serum level of TRP, increased level of 3-HK, and higher suicide risk in adolescent depression.
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Affiliation(s)
- Shuran Yang
- Department of Psychosomatic Medicine, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Jingjing Han
- Department of Psychosomatic Medicine, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Zhihan Ye
- Department of Clinical Laboratory, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Huizhi Zhou
- 920th Hospital of Joint Logistics Support Force, PLA, Yunnan, 650000, Kunming, China
| | - Yangye Yan
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Dong Han
- Department of Psychosomatic Medicine, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Shi Chen
- Department of Psychosomatic Medicine, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Lu Wang
- Department of Psychosomatic Medicine, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Qiang Feng
- Department of Psychosomatic Medicine, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Xudong Zhao
- Department of Psychosomatic Medicine, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
- Clinical Research Center for Mental Disorders, School of Medicine, Chinese-German Institute of Mental Health, Shanghai Pudong New Area Mental Health Center, Tongji University, Shanghai, 200124, China
| | - Chuanyuan Kang
- Department of Psychosomatic Medicine, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China.
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Wang D, Wang J, Yan D, Wang M, Yang L, Demin KA, de Abreu MS, Kalueff AV. Minocycline reduces neurobehavioral deficits evoked by chronic unpredictable stress in adult zebrafish. Brain Res 2024; 1845:149209. [PMID: 39233136 DOI: 10.1016/j.brainres.2024.149209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 08/11/2024] [Accepted: 08/28/2024] [Indexed: 09/06/2024]
Abstract
Chronic stress-related brain disorders are widespread and debilitating, and often cause lasting neurobehavioral deficits. Minocycline, a common antibiotic and an established inhibitor of microglia, emerges as potential treatment of these disorders. The zebrafish (Danio rerio) is an important emerging model organism in translational neuroscience and stress research. Here, we evaluated the potential of minocycline to correct microglia-mediated behavioral, genomic and neuroimmune responses induced by chronic unpredictable stress (CUS) in adult zebrafish. We demonstrated that CUS evoked overt behavioral deficits in the novel tank, light-dark box and shoaling tests, paralleled by elevated stress hormones (CRH, ACTH and cortisol), and upregulated brain expression of the 'neurotoxic M1' microglia-specific biomarker gene (MHC-2) and pro-inflammatory cytokine genes (IL-1β, IL-6 and IFN-γ). CUS also elevated peripheral (whole-body) pro-inflammatory (IL-1β, IFN-γ) and lowered anti-inflammatory cytokines (IL-4 and IL-10), as well as reduced whole-brain serotonin, dopamine and norepinephrine levels, and increased brain dopamine and serotonin turnover. In contrast, minocycline attenuated most of these effects, also reducing CUS-elevated peripheral levels of IL-6 and IFN-γ. Collectively, this implicates microglia in zebrafish responses to chronic stress, and suggests glial pathways as potential evolutionarily conserved drug targets for treating stress-evoked neuropathogenesis. Our findings also support the growing translational value of zebrafish models for understanding complex molecular mechanisms of brain pathogenesis and its therapy.
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Affiliation(s)
- Dongmei Wang
- School of Pharmacy, Southwest University, Chongqing, China
| | - Jingtao Wang
- School of Pharmacy, Southwest University, Chongqing, China
| | - Dongni Yan
- School of Pharmacy, Southwest University, Chongqing, China
| | - Mengyao Wang
- School of Pharmacy, Southwest University, Chongqing, China
| | - Longen Yang
- School of Pharmacy, Southwest University, Chongqing, China; Suzhou Municipal Key Laboratory of Neurobiology and Cell Signaling, School of Science, Xi'an Jiaotong-Liverpool University (XJTLU), Suzhou, China; Department of Biological Sciences, School of Science, Xi'an Jiaotong-Liverpool University (XJTLU), Suzhou, China
| | - Konstantin A Demin
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia
| | - Murilo S de Abreu
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil; Western Caspian University, Baku, Azerbaijan; Moscow Institute of Physics and Technology, Dolgoprudny, Russia.
| | - Allan V Kalueff
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia; Institute of Experimental Medicine, Almazov National Medical Research Center, St. Petersburg, Russia; Suzhou Municipal Key Laboratory of Neurobiology and Cell Signaling, School of Science, Xi'an Jiaotong-Liverpool University (XJTLU), Suzhou, China; Department of Biological Sciences, School of Science, Xi'an Jiaotong-Liverpool University (XJTLU), Suzhou, China; Moscow Institute of Physics and Technology, Dolgoprudny, Russia.
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Tian X, Dong YQ, Yuan JY, Gao Y, Zhang CH, Li MJ, Li J. Association between peripheral plasma cytokine levels and suicidal ideation in first-episode, drug-naïve major depressive disorder. Psychoneuroendocrinology 2024; 165:107042. [PMID: 38613945 DOI: 10.1016/j.psyneuen.2024.107042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/30/2024] [Accepted: 03/31/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Inflammatory processes could potentially impact both mood and suicide risk, however, the relationship between cytokines and suicidal ideation remains unclear. This study aimed to investigate the association between plasma levels of cytokines and suicidal ideation in population with major depressive disorders (MDD). METHODS A cross-sectional study was performed to assess the peripheral plasma levels of interleukin-1β (IL-1β), IL-2, IL-6, IL-8, IL-10 and tumor necrosis factor-α (TNF-α) in 88 Chinese Han first-episode drug-naïve MDD patients. Suicidal ideation in the past week were identified using the Beck Scale for Suicide Ideation-Chinese Version (BSI-CV). The Hamilton Depression Rating Scale-17 (HAMD-17), the Hamilton Anxiety Rating Scale-14 (HAMA-14) and the Childhood Trauma Questionnaire (CTQ) was used to assess depression, anxiety and childhood trauma. Multivariable logistic regression models were used to estimate the association between cytokines and suicidal ideation. Interaction and stratified analyses were conducted according to age, sex, marital status, education, smoking status, BMI and physical activity. RESULTS Among the 88 participants, 42 individuals (47.7%) reported suicidal ideation within the past week. In the fully adjusted model, a statistically significant trend was observed in the association between IL-2 level and suicidal ideation (OR: 1.40, 95% CI: 1.00-1.97). The stratified analysis showed a statistically significant association between IL-6 level and suicidal ideation among younger people (OR: 1.17, 95% CI: 1.01-1.36) and a significant positive association between IL-8 (OR: 1.59, 95% CI: 1.03-2.44) and IL-10 (OR: 2.51, 95% CI: 1.27-4.96) levels and suicide ideation among higher educated populations. LIMITATIONS The cross-sectional design, residual confounding effects and small sample size CONCLUSION: Our findings indicate a significant positive association between plasma IL-2 level and suicidal ideation in MDD patients. IL-2 has the potential to be a biomarker of suicidal ideation in patients with depression.
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Affiliation(s)
- Xue Tian
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Ye-Qing Dong
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Jia-Yu Yuan
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Ying Gao
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Chu-Hao Zhang
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Mei-Juan Li
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Jie Li
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China.
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Lin J, Xiao L, Nie X, Wang Z, Luo Y, Zhang L, Liu Y. Investigating the role of TGF-β and BDNF in cancer-related depression: a primary cross-sectional study. Support Care Cancer 2024; 32:365. [PMID: 38758235 DOI: 10.1007/s00520-024-08542-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/02/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Cancer-related depression is a well-documented condition that significantly impacts long-term quality of life. Brain-derived neurotrophic factor (BDNF), a neurotrophin essential for neurogenesis and neuronal plasticity, has been implicated in various neuropsychological disorders including depression associated with cancer. Cytokines, on the other hand, play a crucial role in regulating depression, potentially by influencing BDNF expression. Transforming growth factor-β (TGF-β), a key immune regulator within the tumor microenvironment, has been found to elevate BDNF levels, establishing a link between peripheral immune responses and depression. The study aims to investigate the correlation of TGF-β and BDNF in cancer-related depression. METHODS This study involved a cohort of 153 gynecological patients, including 61 patients with gynecological cancer and 92 patients without cancer. Depression levels were assessed using the subscale of Hospital Anxiety and Depression Scale (HADS-D), and TGF-β and BDNF plasma levels were measured using enzyme-linked immunosorbent assay (ELISA). RESULTS The study revealed elevated plasma TGF-β levels in patients with cancer (32.24 ± 22.93 ng/ml) compared to those without cancer (25.24 ± 19.72 ng/ml) (P = 0.046). Additionally, reduced levels of BDNF were observed in patients presenting depression symptoms (44.96 ± 41.06 pg/ml) compared to those without depression (133.5 ± 176.7 pg/ml) (P = 0.036). Importantly, a significant correlation between TGF-β and BDNF was found in patients without cancer but with depression (correlation coefficient = 0.893, **P < 0.01). Interestingly, cancer appeared to influence the association between TGF-β and BDNF in patients with depression, as evidenced by a significant difference in the correlation of TGF-β and BDNF between cancer and non-cancer groups (P = 0.041). CONCLUSIONS These findings underscore the active involvement of TGF-β and BDNF crosstalk in the context of cancer-related depression.
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Affiliation(s)
- Jingjing Lin
- School of Nursing, Southern Medical University, Guangzhou, China
- Health College, Zhejiang Industry Polytechnic College, Shaoxing, China
| | - Lin Xiao
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Xinchen Nie
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Zhijian Wang
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yuanyuan Luo
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, Guangzhou, China.
| | - Yawei Liu
- School of Nursing, Southern Medical University, Guangzhou, China.
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McCallum RT, Thériault RK, Manduca JD, Russell ISB, Culmer AM, Doost JS, Martino TA, Perreault ML. Nrf2 activation rescues stress-induced depression-like behaviour and inflammatory responses in male but not female rats. Biol Sex Differ 2024; 15:16. [PMID: 38350966 PMCID: PMC10863247 DOI: 10.1186/s13293-024-00589-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 01/31/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a recurring affective disorder that is two times more prevalent in females than males. Evidence supports immune system dysfunction as a major contributing factor to MDD, notably in a sexually dimorphic manner. Nuclear factor erythroid 2-related factor 2 (Nrf2), a regulator of antioxidant signalling during inflammation, is dysregulated in many chronic inflammatory disorders; however, its role in depression and the associated sex differences have yet to be explored. Here, we investigated the sex-specific antidepressant and immunomodulatory effects of the potent Nrf2 activator dimethyl fumarate (DMF), as well as the associated gene expression profiles. METHODS Male and female rats were treated with vehicle or DMF (25 mg/kg) whilst subjected to 8 weeks of chronic unpredictable stress. The effect of DMF treatment on stress-induced depression- and anxiety-like behaviours, as well as deficits in recognition and spatial learning and memory were then assessed. Sex differences in hippocampal (HIP) microglial activation and gene expression response were also evaluated. RESULTS DMF treatment during stress exposure had antidepressant effects in male but not female rats, with no anxiolytic effects in either sex. Recognition learning and memory and spatial learning and memory were impaired in chronically stressed males and females, respectively, and DMF treatment rescued these deficits. DMF treatment also prevented stress-induced HIP microglial activation in males. Conversely, females displayed no HIP microglial activation associated with stress exposure. Last, chronic stress elicited sex-specific alterations in HIP gene expression, many of which were normalized in animals treated with DMF. Of note, most of the differentially expressed genes in males normalized by DMF were related to antioxidant, inflammatory or immune responses. CONCLUSIONS Collectively, these findings support a greater role of immune processes in males than females in a rodent model of depression. This suggests that pharmacotherapies that target Nrf2 have the potential to be an effective sex-specific treatment for depression.
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Affiliation(s)
- Ryan T McCallum
- Department of Biomedical Sciences, University of Guelph, 50 Stone Rd. E., Guelph, ON, N1G 2W1, Canada
| | - Rachel-Karson Thériault
- Department of Biomedical Sciences, University of Guelph, 50 Stone Rd. E., Guelph, ON, N1G 2W1, Canada
| | - Joshua D Manduca
- Department of Biomedical Sciences, University of Guelph, 50 Stone Rd. E., Guelph, ON, N1G 2W1, Canada
| | - Isaac S B Russell
- Department of Biomedical Sciences, University of Guelph, 50 Stone Rd. E., Guelph, ON, N1G 2W1, Canada
| | - Angel M Culmer
- Department of Biomedical Sciences, University of Guelph, 50 Stone Rd. E., Guelph, ON, N1G 2W1, Canada
| | - Janan Shoja Doost
- Department of Biomedical Sciences, University of Guelph, 50 Stone Rd. E., Guelph, ON, N1G 2W1, Canada
| | - Tami A Martino
- Department of Biomedical Sciences, University of Guelph, 50 Stone Rd. E., Guelph, ON, N1G 2W1, Canada
| | - Melissa L Perreault
- Department of Biomedical Sciences, University of Guelph, 50 Stone Rd. E., Guelph, ON, N1G 2W1, Canada.
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Chi S, Mok YE, Lee JH, Suh SI, Han C, Lee MS. Functional connectivity and network analysis in adolescents with major depressive disorder showing suicidal behavior. J Affect Disord 2023; 343:42-49. [PMID: 37741467 DOI: 10.1016/j.jad.2023.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 08/28/2023] [Accepted: 09/18/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND This study aimed to gather a homogeneous sample of adolescent patients to analyze the differences in functional connectivity and brain network parameters between suicidal and non-suicidal major depressive disorder (MDD) patients using a data-driven whole-brain approach. METHODS Patients recruited at the psychiatry department of Korea University Guro Hospital from November 2014 to March 2020 were diagnosed with MDD, were 13-18 years old, had IQ scores >80, had no family history of psychotic or personality disorders, had no smoking or alcohol consumption history, and were drug-naïve to psychotropic medication. Depressive symptoms were assessed using the Hamilton Depression Rating Scale and the Children's Depression Inventory. Structural and functional MRI scans were conducted and analyzed using the CONN toolbox. RESULTS Of 74 enrolled patients, 62 were analyzed. Regions of interest (ROIs) showing higher betweenness centrality in non-suicidal patients were the left superior temporal gyrus and left supramarginal gyrus. ROIs showing higher betweenness centrality in suicidal patients were the right hippocampus, left intracalcarine cortex, right inferior temporal gyrus, and the lateral visual network. Suicidal patients also showed different resting state functional connectivity profiles from non-suicidal patients. LIMITATIONS Small sample size. CONCLUSION Suicidal patients may overthink and overvalue future risks while having a more negatively biased autobiographical memory. Social cognition and the ability to overcome egocentricity bias seem to weaken. Such features can disrupt cognitive recovery and resilience, leading to more suicidal behaviors. Therefore, increased suicidality is not acquired, but is an innate trait.
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Affiliation(s)
- SuHyuk Chi
- Department of Psychiatry, Korea University Guro Hospital, Seoul, South Korea
| | - Young Eun Mok
- Department of Psychiatry, Korea University Guro Hospital, Seoul, South Korea
| | - Jong-Ha Lee
- Department of Psychiatry, Korea University Ansan Hospital, Ansan, South Korea
| | - Sang-Il Suh
- Department of Radiology, Korea University Guro Hospital, Seoul, South Korea
| | - Changsu Han
- Department of Psychiatry, Korea University Guro Hospital, Seoul, South Korea
| | - Moon-Soo Lee
- Department of Psychiatry, Korea University Guro Hospital, Seoul, South Korea.
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Li Y, Wang H, Zhou J, Wang C. Research progress on the correlation between transforming growth factor- β level and symptoms of depression. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:646-652. [PMID: 37916311 PMCID: PMC10630060 DOI: 10.3724/zdxbyxb-2023-0269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/19/2023] [Indexed: 10/08/2023]
Abstract
Transforming growth factor (TGF)-β is a group of cytokines with anti-inflammatory effects in the TGF family, which participates in the development of stress and depression-related mechanisms, and plays roles in the regulation of inflammatory response in depression and the recovery of various cytokine imbalances. The core symptoms of depression is associated with TGF-β level, and the psychological symptoms of depression are related to TGF-β gene polymorphism. Various antidepressants may up-regulate TGF-β level through the complex interaction between neurotransmitters and inflammatory factors, inhibiting inflammatory response and regulating cytokine imbalance to improve depressive symptoms. Studies have shown that recombinant TGF-β1 protein has beneficial effects in mouse depression models, indicating TGF-β1 might be a potential therapeutic target for depression and nasal sprays having the advantage of being fast acting delivery method. This article reviews the research progress on dynamic changes of TGF-β level before and after depression treatment and the application of TGF-β level as an indicator for the improvement of depressive symptoms. We provide ideas for the development of new antidepressants and for the evaluation of the treatment efficacy in depression.
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Affiliation(s)
- Yanran Li
- Department of Psychiatry, the Second Affiliated Hospital of Xinxiang Medical College, Henan Key Laboratory of Biological Psychiatry, Henan Psychological Aid Cloud Platform and Application Engineering Research Center, Xinxiang 453002, Henan Province, China.
| | - Huiying Wang
- Department of Psychiatry, the Second Affiliated Hospital of Xinxiang Medical College, Henan Key Laboratory of Biological Psychiatry, Henan Psychological Aid Cloud Platform and Application Engineering Research Center, Xinxiang 453002, Henan Province, China
| | - Jiansong Zhou
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, National Clinical Medical Research Center for Ment, Changsha 410011, China.
| | - Changhong Wang
- Department of Psychiatry, the Second Affiliated Hospital of Xinxiang Medical College, Henan Key Laboratory of Biological Psychiatry, Henan Psychological Aid Cloud Platform and Application Engineering Research Center, Xinxiang 453002, Henan Province, China.
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Shindo R, Tanifuji T, Okazaki S, Otsuka I, Shirai T, Mouri K, Horai T, Hishimoto A. Accelerated epigenetic aging and decreased natural killer cells based on DNA methylation in patients with untreated major depressive disorder. NPJ AGING 2023; 9:19. [PMID: 37673891 PMCID: PMC10482893 DOI: 10.1038/s41514-023-00117-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 06/29/2023] [Indexed: 09/08/2023]
Abstract
Major depressive disorder (MDD) is known to cause significant disability. Genome-wide DNA methylation (DNAm) profiles can be used to estimate biological aging and as epigenetic clocks. However, information on epigenetic clocks reported in MDD patients is inconsistent. Since antidepressants are likely confounders, we evaluated biological aging using various DNAm-based predictors in patients with MDD who had never received depression medication. A publicly available dataset consisting of whole blood samples from untreated MDD patients (n = 40) and controls (n = 40) was used. We analyzed five epigenetic clocks (HorvathAge, HannumAge, SkinBloodAge, PhenoAge, and GrimAge), DNAm-based telomere length (DNAmTL), and DNAm-based age-related plasma proteins (GrimAge components), as well as DNAm-based white blood cell composition. The results indicate that patients with untreated MDD were significantly associated with epigenetic aging acceleration in HannumAge and GrimAge. Furthermore, a decrease in natural killer cells, based on DNAm, was observed in patients with untreated MDD.
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Affiliation(s)
- Ryota Shindo
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takaki Tanifuji
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Satoshi Okazaki
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Ikuo Otsuka
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshiyuki Shirai
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kentaro Mouri
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tadasu Horai
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
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10
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Integrating functional neuroimaging and serum proteins improves the diagnosis of major depressive disorder. J Affect Disord 2023; 325:421-428. [PMID: 36642308 DOI: 10.1016/j.jad.2023.01.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 12/25/2022] [Accepted: 01/08/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND The lack of effective objective diagnostic biomarkers for major depressive disorder (MDD) leads to high misdiagnosis. Compared with healthy controls (HC), abnormal brain functions and protein levels are often observed in MDD. However, it is unclear whether combining these changed multidimensional indicators could help improve the diagnosis of MDD. METHODS Sixty-three MDD and eighty-one HC subjects underwent resting-state fMRI scans, among whom 37 MDD and 45 HC provided blood samples. Amplitudes of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), and serum levels of brain-derived neurotrophic factor (BDNF), cortisol, and multiple cytokines were measured and put into the linear discriminant analysis (LDA) to construct corresponding MDD diagnostic models. The area under the receiver operating characteristic curve (AUC) of 5-fold cross-validation was calculated to evaluate each model's performance. RESULTS Compared with HC, MDD patients' spontaneous brain activity, serum BDNF, cortisol, interleukin (IL)-4, IL-6, and IL-10 levels changed significantly. The combinations of unidimensional multi-indicator had better diagnostic performance than a single one. The model consisted of multidimensional multi-indicator further exhibited conspicuously superior diagnostic efficiency than those constructed with unidimensional multi-indicator, and its AUC, sensitivity, specificity, and accuracy of 5-fold cross-validation were 0.99, 92.0 %, 100.0 %, and 96.3 %, respectively. LIMITATIONS This cross-sectional study consists of relatively small samples and should be replicated in larger samples with follow-up data to optimize the diagnostic model. CONCLUSIONS MDD patients' neuroimaging features and serum protein levels significantly changed. The model revealed by LDA could diagnose MDD with high accuracy, which may serve as an ideal diagnostic biomarker for MDD.
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11
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Serafini G, Costanza A, Aguglia A, Amerio A, Trabucco A, Escelsior A, Sher L, Amore M. The Role of Inflammation in the Pathophysiology of Depression and Suicidal Behavior: Implications for Treatment. Med Clin North Am 2023; 107:1-29. [PMID: 36402492 DOI: 10.1016/j.mcna.2022.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Depression and suicidal behavior are 2 complex psychiatric conditions of significant public health concerns due to their debilitating nature. The need to enhance contemporary treatments and preventative approaches for these illnesses not only calls for distillation of current views on their pathogenesis but also provides an impetus for further elucidation of their novel etiological determinants. In this regard, inflammation has recently been recognized as a potentially important contributor to the development of depression and suicidal behavior. This review highlights key evidence that supports the presence of dysregulated neurometabolic and immunologic signaling and abnormal interaction with microbial species as putative etiological hallmarks of inflammation in depression as well as their contribution to the development of suicidal behavior. Furthermore, therapeutic insights addressing candidate mechanisms of pathological inflammation in these disorders are proposed.
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Affiliation(s)
- Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy.
| | - Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland, Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland; Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland (USI), Lugano, Switzerland
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy
| | - Alice Trabucco
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Andrea Escelsior
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy
| | - Leo Sher
- James J. Peters VA Medical Center, Bronx, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, New York, NY, USA
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy
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12
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Abstract
BACKGROUND Dysregulated proinflammatory cytokines have been shown to be associated with suicidal behavior. Cognitive deficits in working memory and inhibitory control have been demonstrated in depressed patients and people with suicidal ideation (SI). However, the association between proinflammatory cytokines, SI, and cognitive deficits in patients with major depressive disorder (MDD) remains unclear. METHODS A total of 77 patients with MDD and age-/sex-matched 60 healthy individuals were recruited. MDD patients were divided into two groups: with SI (n = 36) and no SI (n = 41). SI was defined by a score of ≥2 in item 3 of the 17-item Hamilton Rating Scale for Depression. Levels of proinflammatory cytokines, including soluble interleukin-6 receptor, soluble tumor necrosis factor-α receptor type 1, and C-reactive protein (CRP), were measured, and cognitive function was assessed using 2-back task and Go/No-Go task. RESULTS Patients with SI had higher levels of CRP than those without SI and controls (P = .007). CRP was positively associated with SI (β = 0.21, P = .037), independent of cognitive function and depressive symptoms. Furthermore, SI was associated with cognitive deficits in working memory and inhibitory control after adjusting for confounding factors (P < .05). CONCLUSION Our findings suggest that higher levels of serum CRP and deficits in working memory and inhibitory control may be associated with higher SI among patients with MDD.
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13
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Xu Y, Liang J, Gao W, Sun Y, Zhang Y, Shan F, Ge J, Xia Q. Peripheral blood cytokines as potential diagnostic biomarkers of suicidal ideation in patients with first-episode drug-naïve major depressive disorder. Front Public Health 2022; 10:1021309. [PMID: 36420006 PMCID: PMC9678225 DOI: 10.3389/fpubh.2022.1021309] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/24/2022] [Indexed: 11/09/2022] Open
Abstract
Objective Major Depressive Disorder (MDD) is a leading cause of disability, with a high risk of suicidal ideation (SI). Few studies have evaluated the potential of multiple cytokines as biomarkers for SI in patients with MDD. In the present study, we examined the serum levels of multiple cytokines in patients with first-episode drug-naïve MDD, with the aim to discover and identify serum cytokines-based biomarkers for identification of SI in MDD. Methods A total of 55 patients with first-episode drug-naïve MDD were enrolled and divided into two groups: 26 MDD patients without SI and 29 MDD patients with SI. Beck Scale for Suicide Ideation was used to estimate SI. A total of 37 cytokines were measured using Multiplex Luminex Assays. The levels of serum cytokines between MDD patients without SI and MDD patients with SI were compared and diagnostic values of different cytokines were evaluated using the receiver operating characteristic (ROC) curve method for discriminating MDD patients with SI from MDD patients without SI. The relationship between the group and the abnormal cytokines were investigated in multiple linear regression models, with adjustments for age, gender, BMI, smoking, and Hamilton Depression Rating Scale-24 (HAMD-24) scores. Results The levels of CCL26 and VEGF in MDD patients with SI were significantly lower than those in MDD patients without SI (all P < 0.05). On the contrary, the levels of IL-17C, CXCL10, and TNF-β in MDD patients with SI were significantly higher than those in MDD patients without SI (all P < 0.05). Moreover, the results of multiple linear regression revealed that group was a significant independent predictor of serum IL-17C, CCL-26, VEGF, and TNF-β levels (all P < 0.05). In terms of CXC10, group was also likely to be a significant independent predictor (β = 0.257, P = 0.063). Furthermore, the AUC values of IL-17C and TNF-β were 0.728 and 0.732, respectively. Additionally, a combined panel of IL-17C and TNF-β achieved a high accuracy in discriminating MDD patients with SI from MDD patients without SI (AUC = 0.848, sensitivity = 75.9%, specificity = 72.7%). Conclusions These results suggested that circulating IL-17C and TNF-β may hold promise in the discovery of biomarkers for identification of SI in MDD.
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Affiliation(s)
- Yayun Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China,The Key Laboratory of Anti-Inflammatory and Immune Medicines, Ministry of Education, Hefei, China
| | - Jun Liang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China,Department of Pharmacy, Hefei Fourth People's Hospital, Hefei, China,Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, China,Anhui Clinical Research Center for Mental Disorders, Hefei, China
| | - Wenfan Gao
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China,Department of Pharmacy, Hefei Fourth People's Hospital, Hefei, China,Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, China,Anhui Clinical Research Center for Mental Disorders, Hefei, China
| | - Yanhong Sun
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China,Department of Pharmacy, Hefei Fourth People's Hospital, Hefei, China,Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, China,Anhui Clinical Research Center for Mental Disorders, Hefei, China
| | - Yuanyuan Zhang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China,Department of Pharmacy, Hefei Fourth People's Hospital, Hefei, China,Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, China,Anhui Clinical Research Center for Mental Disorders, Hefei, China
| | - Feng Shan
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China,Department of Pharmacy, Hefei Fourth People's Hospital, Hefei, China,Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, China,Anhui Clinical Research Center for Mental Disorders, Hefei, China
| | - Jinfang Ge
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China,School of Pharmacy, Anhui Medical University, Hefei, China,*Correspondence: Jinfang Ge
| | - Qingrong Xia
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China,Department of Pharmacy, Hefei Fourth People's Hospital, Hefei, China,Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, China,Anhui Clinical Research Center for Mental Disorders, Hefei, China,Qingrong Xia
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14
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Associations of three major physiological stress systems with suicidal ideation and suicide attempts in patients with a depressive and/or anxiety disorder. Brain Behav Immun 2022; 102:195-205. [PMID: 35202735 DOI: 10.1016/j.bbi.2022.02.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/30/2022] [Accepted: 02/18/2022] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND People with depressive and/or anxiety disorders are at increased risk of suicidal ideation and suicide attempts, but biological correlates signaling such risk remain unclear. Independent and cumulative dysregulations in physiological stress systems, in particular the hypothalamic-pituitaryadrenal axis (HPA-axis), immune-inflammatory system, and autonomous nervous system (ANS), may contribute to this risk. However, findings have either been heterogeneous or absent thus far. METHODS Associations between individual markers and cumulative indices of the HPA-axis (cortisol awakening response and evening cortisol), immune-inflammatory system (C-reactive protein, interleukin-6 (IL-6), and tumor necrosis factor-α), and the ANS (heart rate, respiratory sinus arrhythmia, and pre-ejection period) and the outcomes no suicide ideation with suicide attempt (SI-SA+), suicide ideation without suicide attempt (SI+SA-) and suicide ideation with suicide attempt (SI+SA+) were investigated in 1749 persons with depressive and/or anxiety disorders from the Netherlands Study of Depression and Anxiety (NESDA). RESULTS High levels of CRP and IL-6 were associated with SI-SA+ and SI+SA+ respectively when compared to non-suicidal patients after adjusting for confounders and multiple testing. Also, cumulative immune-inflammatory dysregulations were positively associated with SI+SA+, suggesting a dose-response effect. No significant associations were found between HPA-axis or ANS indicators and suicide-outcomes and between immune-inflammatory system markers or cumulative stress system dysregulations and SI+SA-. CONCLUSION Although stress system markers could not differentiate between SI+SA- and non-suicidal patients, findings indicate that dysregulations of individual and cumulative immune-inflammatory markers are associated with suicide attempts in depressive and/or anxiety patients. Thus, immune-inflammatory system dysregulation may be involved in the pathophysiology of suicidal behavior, supporting further examination of the effects of anti-inflammatory interventions on suicidality.
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15
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Costanza A, Amerio A, Aguglia A, Serafini G, Amore M, Hasler R, Ambrosetti J, Bondolfi G, Sampogna G, Berardelli I, Fiorillo A, Pompili M, Nguyen KD. Hyper/neuroinflammation in COVID-19 and suicide etiopathogenesis: Hypothesis for a nefarious collision? Neurosci Biobehav Rev 2022; 136:104606. [PMID: 35289272 PMCID: PMC8916836 DOI: 10.1016/j.neubiorev.2022.104606] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/23/2022] [Accepted: 03/06/2022] [Indexed: 11/24/2022]
Abstract
Accumulating scientific and clinical evidence highlighted pathological hyperinflammation as a cardinal feature of SARS-CoV-2 infection and acute COVID-19 disease. With the emergence of long COVID-19 syndrome, several chronic health consequences, including neuropsychiatric sequelae, have gained attention from the public and medical communities. Since inflammatory mediators have also been accredited as putative biomarkers of suicidal ideations and behaviors, hyper- and neuroinflammation might share some colliding points, overlapping and being interconnected in the context of COVID-19. This review aims to provide a summary of current knowledge on the molecular and cellular mechanisms of COVID-19-associated hyper/neuroinflammation with focus on their relevance to the inflammatory hypothesis of suicide development. Subsequently, strategies to alleviate COVID-19 hyper/neuroinflammation by immunomodulatory agents (many of which at experimental stages) as well as psychopharmacologic/psychotherapeutic approaches are also mentioned. While suicide risk in COVID-19 survivors - until now little known - needs further analysis through longitudinal studies, current observations and mechanistic postulates warrant additional attention to this possibly emerging mental health concern.
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Affiliation(s)
- A Costanza
- Departement of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland.
| | - A Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - A Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - G Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - M Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - R Hasler
- Departement of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Department of Psychiatry, Service of Psychiatric Specialties, University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - J Ambrosetti
- Department of Psychiatry and Department of Emergency, Emergency Psychiatric Unit (UAUP), Geneva University Hospitals (HUG), Geneva, Switzerland
| | - G Bondolfi
- Departement of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland; Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention (SPLIC), University Hospitals (HUG), Geneva, Switzerland
| | - G Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - I Berardelli
- Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - A Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - M Pompili
- Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - K D Nguyen
- Tranquis Therapeutics, Palo Alto, CA, USA; Department of Microbiology and Immunology, Stanford University, Palo Alto, CA, USA
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16
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Fernández-Sevillano J, González-Ortega I, MacDowell K, Zorrilla I, López MP, Courtet P, Gabilondo A, Martínez-Cengotitabengoa M, Leza JC, Sáiz P, González-Pinto A. Inflammation biomarkers in suicide attempts and their relation to abuse, global functioning and cognition. World J Biol Psychiatry 2022; 23:307-317. [PMID: 34730074 DOI: 10.1080/15622975.2021.1988703] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To explore the link between cytokines and suicide attempts and their relationship with the psychological aspects of this complex multifactorial phenomenon. METHODS 96 participants, including 20 patients with a recent suicide attempt and diagnosis of Major Depression Disorder (MDD), 33 MDD patients with a lifetime history of suicide attempt, 23 non-attempter MDD patients, and 20 healthy controls underwent an assessment on depressive symptoms, global functioning, aggressive behaviour, presence of abuse and attention performance. Additionally, all participants had a blood extraction for IL-2, IL2-R, IL-4, IL-6, and TNF-α plasma levels analysis. RESULTS IL-6 levels were significantly different across groups (F(3,89)=3.690; p = 0.015), with higher concentrations in both recent (p = 0.04) and distant (p = 0.015) attempt in comparison to MDD non-attempters. IL-6 was associated with adult physical abuse (B = 2.591; p = 0.021), lower global functioning score (B = -0.512; p = 0.011), and poorer performance on attention (B = -0.897; p = 0.011). CONCLUSIONS Recent and distant suicidal behaviour is associated with elevated IL-6 levels, which may be influenced by stressful and traumatic experiences. Elevated concentrations of IL-6 could have a negative impact on attention, increasing suicide risk. More research is needed to clarify the role of cytokines in suicide-related features to explore novel treatments and more effective preventive interventions.
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Affiliation(s)
- Jessica Fernández-Sevillano
- Department of Neuroscience, University of the Basque Country UPV/EHU, Leioa, Spain.,Bioaraba Research Institute, Severe Mental Disorder Research Group, Vitoria-Gasteiz, Spain.,Department of Psychiatry, Araba University Hospital, OSIARABA, Osakidetza, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Itxaso González-Ortega
- Bioaraba Research Institute, Severe Mental Disorder Research Group, Vitoria-Gasteiz, Spain.,Department of Psychiatry, Araba University Hospital, OSIARABA, Osakidetza, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Karina MacDowell
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain.,Department of Pharmacology & Toxicology, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain.,Instituto de Investigación Hospital 12 de Octubre (i + 12), IUIN-UCM, Madrid, Spain
| | - Iñaki Zorrilla
- Department of Neuroscience, University of the Basque Country UPV/EHU, Leioa, Spain.,Bioaraba Research Institute, Severe Mental Disorder Research Group, Vitoria-Gasteiz, Spain.,Department of Psychiatry, Araba University Hospital, OSIARABA, Osakidetza, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - María Purificación López
- Department of Neuroscience, University of the Basque Country UPV/EHU, Leioa, Spain.,Bioaraba Research Institute, Severe Mental Disorder Research Group, Vitoria-Gasteiz, Spain.,Department of Psychiatry, Araba University Hospital, OSIARABA, Osakidetza, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Philippe Courtet
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, University of Montpellier, Montpellier, France
| | - Andrea Gabilondo
- Mental Health and Psychiatric Care Research Unit, BioDonostia Health Research Institute, Donostia-San Sebastián, Spain.,Outpatient Mental Health Network, Osakidetza, Donostia-San Sebastián, Spain
| | - Mónica Martínez-Cengotitabengoa
- Department of Neuroscience, University of the Basque Country UPV/EHU, Leioa, Spain.,Psychology Clinic of East Anglia, Norwich, United Kingdom
| | - Juan Carlos Leza
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain.,Department of Pharmacology & Toxicology, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain.,Instituto de Investigación Hospital 12 de Octubre (i + 12), IUIN-UCM, Madrid, Spain
| | - Pilar Sáiz
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain.,Department of Psychiatry, Universidad de Oviedo. Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Ana González-Pinto
- Department of Neuroscience, University of the Basque Country UPV/EHU, Leioa, Spain.,Bioaraba Research Institute, Severe Mental Disorder Research Group, Vitoria-Gasteiz, Spain.,Department of Psychiatry, Araba University Hospital, OSIARABA, Osakidetza, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
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17
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Tamimou R, Lumbroso S, Mouzat K, Lopez-Castroman J. Genetic variations related to inflammation in suicidal ideation and behavior: A systematic review. Front Psychiatry 2022; 13:1003034. [PMID: 36325529 PMCID: PMC9621324 DOI: 10.3389/fpsyt.2022.1003034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND/OBJECTIVES Immune-inflammatory changes have been found in all types of suicidal ideation and behavior (SIB), independently of associated mental disorders. Since several Single Nucleotide Polymorphisms (SNPs) affect the function of inflammation-related genes, we searched the literature for genetic variations potentially altering inflammatory processes in SIB. METHODS We included studies that looked for associations between SIB and SNPs in genes related to inflammatory processes. Case reports, literature reviews, and animal studies were excluded. Articles were retrieved from PubMed and PsycINFO databases, Google Scholar and GreySource Index until September 17th, 2022. Quality was assessed using Q-Genie. RESULTS We analyzed 32 studies. SIB has been associated with eighteen SNPs located in genes encoding for interleukin-8 (rs4073), C-reactive protein (rs1130864), tumor necrosis factor α (rs1800629, rs361525, and rs1099724), tumor necrosis factor receptor 2 (rs1061622), transforming growth factor β-1 (rs1982073), acid phosphatase 1 (rs7419262, rs300774), interleukin-10 (rs1800896), interferon γ (rs2430561), amino-carboxy muconate semialdehyde decarboxylase (rs2121337), interleukin 7 (rs10448044, rs10448042), macrophage migration inhibitory factor (rs755622), interleukin 1-α (rs1800587), and interleukin 1-β (rs1143634 and rs16944. A genome-wide association study reported one association at the threshold of significance with the rs300774 SNP, located in the 2p25 region containing ACP1 gene. DISCUSSION The studies included were methodologically and clinically diverse and of moderate quality. Their findings suggest that some inflammation-related SNPs could increase the likelihood of SIB but the evidence to date is insufficient. Further research using gene-gene (GxG) and gene-environment (GxE) approaches is warranted. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk], identifier [CRD42022296310].
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Affiliation(s)
- Rabah Tamimou
- Department of Psychiatry, Nimes University Hospital, Nimes, France.,Laboratory of Biochemistry and Molecular Biology, Nimes University Hospital, University of Montpellier, Nimes, France.,Institut de Génomique Fonctionnelle, University of Montpellier, CNRS-INSERM, Montpellier, France
| | - Serge Lumbroso
- Laboratory of Biochemistry and Molecular Biology, Nimes University Hospital, University of Montpellier, Nimes, France
| | - Kevin Mouzat
- Laboratory of Biochemistry and Molecular Biology, Nimes University Hospital, University of Montpellier, Nimes, France
| | - Jorge Lopez-Castroman
- Department of Psychiatry, Nimes University Hospital, Nimes, France.,Institut de Génomique Fonctionnelle, University of Montpellier, CNRS-INSERM, Montpellier, France.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
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18
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Vasupanrajit A, Jirakran K, Tunvirachaisakul C, Maes M. Suicide attempts are associated with activated immune-inflammatory, nitro-oxidative, and neurotoxic pathways: A systematic review and meta-analysis. J Affect Disord 2021; 295:80-92. [PMID: 34416621 DOI: 10.1016/j.jad.2021.08.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Suicide attempts (SA) frequently occur in patients with mood disorders and schizophrenia, which are both accompanied by activated immune-inflammatory and nitro-oxidative (IO&NS) pathways. METHODS We searched PubMed, Google Scholar, and Web of Science, for articles published from inception until February 1, 2021. We included studies that compared blood biomarkers in psychiatric patients with (SA+) and without SA (SA-) and heathy controls and we combined different IO&NS biomarkers into immune, inflammatory, and neurotoxic profiles and used meta-analysis (random-effect model with restricted maximum-likelihood) to delineate effect sizes with 95% confidence interval (CI). FINDINGS Our search included 51 studies comprising 4.945 SA+ patients and 24.148 controls. We stratified the control group into healthy controls and SA- patients. SA+ patients showed significantly (p<0.001) increased immune activation (SMD: 1.044; CI: 0.599, 1.489), inflammation (SMD: 1.109; CI: 0.505, 1.714), neurotoxicity (SMD: 0.879; CI: 0.465, 1.293), and lowered neuroprotection (SMD: 0.648; CI: 0.354, 0.941) as compared with healthy controls. When compared with SA- patients, those with SA+ showed significant (p<0.001) immune activation (SMD: 0.290; CI: 0.183, 0.397), inflammation (SMD: 0.311; CI: 0.191, 0.432), and neurotoxicity (SMD: 0.315; CI: 0.198, 0.432), and lowered neuroprotection (SMD: 0.341; CI: 0.167, 0.515). Patients with current, but not lifetime, SA showed significant (p<0.001) levels of inflammation and neurotoxicity as compared with controls. CONCLUSIONS Patients with immune activation are at a higher risk of SA which may be explained by increased neurotoxicity due to inflammation and nitro-oxidative stress. This meta-analysis discovered new biomarkers of SA and therapeutic targets to treat individuals with SA.
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Affiliation(s)
- Asara Vasupanrajit
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Ketsupar Jirakran
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Maximizing Thai Children's Developmental Potential Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chavit Tunvirachaisakul
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Cognitive Impairment and Dementia Research Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Cognitive Impairment and Dementia Research Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; IMPACT Strategic Research Center, Deakin University, Geelong, Australia; Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria.
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Czysz AH, Mason BL, Li Q, Chin-Fatt C, Minhajuddin A, Carmody T, Trivedi MH. Comparison of inflammatory markers as moderators of depression outcomes: A CO-MED study. J Affect Disord 2021; 295:1066-1071. [PMID: 34706415 DOI: 10.1016/j.jad.2021.08.116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/30/2021] [Accepted: 08/28/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Prior work suggests some individual immunomarkers may be useful moderators of treatment response between antidepressant medications. The relative moderating effect of individual immunomarkers remains unclear. It is also unknown whether combinations of immunomarkers have a superior moderating effect compared to any individual immunomarker. METHODS Baseline immunomarker levels were assayed using multiplex from a subset of participants in the CO-MED trial (n = 143). Individual and combinations of 19 immunomarkers were modeled as moderators between the three treatment arms (escitalopram monotherapy, escitalopram-bupropion and venlafaxine-mirtazapine) across a variety of depression outcomes. RESULTS Only IL-13 demonstrated a consistent moderating effect across all depression outcome measures. High IL-13 (>20 pg/ml) was associated with higher remission rates to bupropion-escitalopram (67%) versus escitalopram (24%) whereas low IL-13 was associated higher remission rates to escitalopram (59%) versus bupropion-escitalopram (38%). A similar, but weaker moderating effect was observed with venlafaxine-mirtazapine versus escitalopram. The addition of multiple immunomarkers did not consistently improve predictive modeling. LIMITATIONS This is a secondary analysis of a single clinical trial with a relatively small sample size per treatment arm. The testing of specific individual and combinations of biomarkers was data-driven. CONCLUSIONS Among 19 immunomarkers, Il-13 was the best single moderator of treatment outcome. Combinations of immunomarkers were not meaningfully superior to Il-13.
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Affiliation(s)
- Andrew H Czysz
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Brittany L Mason
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Qiwei Li
- Department of Mathematical Sciences, University of Texas Dallas, Richardson, TX, United States of America
| | - Cherise Chin-Fatt
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Abu Minhajuddin
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Thomas Carmody
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States of America.
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20
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Massardo T, Quintana JC, Jaimovich R, Sáez CG, Risco L, Liberman C, Araya AV, Galleguillos T, Castro-Mora G, Pereira J. Regional Brain Perfusion Is Associated with Endothelial Dysfunction Markers in Major Depressive Disorder. Neuropsychobiology 2021; 80:214-224. [PMID: 32726779 DOI: 10.1159/000508110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 04/20/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is an important independent risk factor for cardiovascular disease. Cumulative data suggest that depressive patients exhibit derangement in regional cerebral blood flow (rCBF), although underlying mechanisms remain mostly unknown. Endothelial dysfunction (ED), defined as different forms of abnormal endothelial activity, plays a key role in the pathogenesis of vascular disease. ED is associated with several clinical conditions characterized by high cardiovascular risk. Diverse ED markers have been found in mood disorders. PURPOSE To evaluate the association between rCBF and peripheral ED markers in MDD patients, at baseline and after selective serotonin receptor inhibitors (SSRIs) therapy. PATIENTS AND METHODS Twenty-seven untreated unipolar MDD patients in their first episode were evaluated with the Hamilton Depression Rating Scale (HAM-D) and brain perfusion SPECT at baseline and after 2 months of SSRIs. Statistical Parametric Mapping (SPM) was employed to evaluate rCBF; circulating endothelial cells (CECs), plasma soluble intercellular adhesion molecule (sICAM), and high-sensitivity C-reactive protein (hsCRP) were used as independent covariates. RESULTS Baseline CECs and sICAM were increased in MDD patients compared with matching controls (p = 0.0001) and hsCRP (p = 0.03). HAM-D scores (21 items) and CECs diminished after SSRI therapy in MDD patients (p < 0.0001). There was a significant rCBF decrease, mainly in deep central structures. HAM-D change was associated with rCBF decrease at the left amygdala, right striatum levels, and Brodmann area 25. CEC change was associated with rCBF at deep brain level and sICAM with large rCBF areas at the left caudate and tectum; hsCRP was associated, to a lesser extent, with the left dorsal striatum and mesencephalic tectum. CONCLUSION ED markers in patients with MDD are associated with significant changes in rCBF which are features of depression. These findings suggest that systemic damage/activation of the endothelium may contribute to the abnormal rCBF observed in MDD patients.
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Affiliation(s)
- Teresa Massardo
- Nuclear Medicine Section, Department of Medicine, University of Chile Clinical Hospital, Santiago, Chile
| | - Juan Carlos Quintana
- Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo Jaimovich
- Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia G Sáez
- Department of Hematology-Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis Risco
- Universitary Psychiatric Clinic, University of Chile Clinical Hospital, Santiago, Chile
| | - Claudio Liberman
- Endocrinology Section, Department of Medicine, University of Chile Clinical Hospital, Santiago, Chile
| | - Aída Verónica Araya
- Endocrinology Section, Department of Medicine, University of Chile Clinical Hospital, Santiago, Chile
| | - Tamara Galleguillos
- Universitary Psychiatric Clinic, University of Chile Clinical Hospital, Santiago, Chile
| | - Gabriel Castro-Mora
- Nuclear Medicine Section, Department of Medicine, University of Chile Clinical Hospital, Santiago, Chile
| | - Jaime Pereira
- Department of Hematology-Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile,
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21
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McCallum RT, Perreault ML. Glycogen Synthase Kinase-3: A Focal Point for Advancing Pathogenic Inflammation in Depression. Cells 2021; 10:cells10092270. [PMID: 34571919 PMCID: PMC8470361 DOI: 10.3390/cells10092270] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/26/2021] [Accepted: 08/28/2021] [Indexed: 01/03/2023] Open
Abstract
Increasing evidence indicates that the host immune response has a monumental role in the etiology of major depressive disorder (MDD), motivating the development of the inflammatory hypothesis of depression. Central to the involvement of chronic inflammation in MDD is a wide range of signaling deficits induced by the excessive secretion of pro-inflammatory cytokines and imbalanced T cell differentiation. Such signaling deficits include the glutamatergic, cholinergic, insulin, and neurotrophin systems, which work in concert to initiate and advance the neuropathology. Fundamental to the communication between such systems is the protein kinase glycogen synthase kinase-3 (GSK-3), a multifaceted protein critically linked to the etiology of MDD and an emerging target to treat pathogenic inflammation. Here, a consolidated overview of the widespread multi-system involvement of GSK-3 in contributing to the neuropathology of MDD will be discussed, with the feed-forward mechanistic links between all major neuronal signaling pathways highlighted.
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Affiliation(s)
- Ryan T. McCallum
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada;
| | - Melissa L. Perreault
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada;
- Collaborative Program in Neuroscience, University of Guelph, Guelph, ON N1G 2W1, Canada
- Correspondence: ; Tel.: +1-(519)-824-4120 (ext. 52013)
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22
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González-Castro TB, Tovilla-Zárate CA, López-Narváez ML, Genis-Mendoza AD, Juárez-Rojop IE. Interleukin-6 Levels in Serum, Plasma, and Cerebral Spinal Fluid in Individuals with Suicide Behavior: Systematic Review and Meta-Analysis with Meta-Regression. J Interferon Cytokine Res 2021; 41:258-267. [PMID: 34280025 DOI: 10.1089/jir.2020.0265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Evidence suggests that interleukin-6 (IL-6) concentrations have an important role in suicide behavior (SB) as they are usually increased in these individuals, although no conclusive outcomes have been attained. The purpose of this study was to evaluate the IL-6 levels in plasma, serum, and cerebral spinal fluid (CSF) to determine through a meta-analysis if these levels are increased in individuals with SB in comparison to a group. We calculated the standardized mean difference and 95% confidence intervals (95% CIs). In the systematic review, 21 studies were included, while in the meta-analysis, we included nine studies. The results of our meta-analysis indicated that individuals with SB had reduced levels of IL-6 in plasma (d - 0.189, 95% CI: -0.274 to -0.103, Z, P (Q) = 0.339, I2 = 7.478), but increased levels of IL-6 in serum (d - 1.14, 95% CI: 0.658 to 1.630, Z, P (Q) = 0.26, I2 = 7.47) and CSF (d 0.64, 95% CI: 0.245 to 1.035, Z, P (Q) = 0.163, I2 = 44.80). The meta-regression analysis showed an association between males and high IL-6 levels in plasma (P = 0.003) and serum (P = 0.010), but not the central nervous system (CNS), while age was not associated with IL-6 levels in any of the samples evaluated (plasma, serum, or CNS). The present meta-analysis indicates that serum and CNS IL-6 levels are increased in individuals with SB, while plasma IL-6 levels are decreased, highlighting the importance of the biological sample at the moment of selecting IL-6 as biomarker. However, we need more studies performed in different populations that measure IL-6 and also consider gender when these measures are performed.
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Affiliation(s)
- Thelma Beatriz González-Castro
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, México
| | | | | | - Alma Delia Genis-Mendoza
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México, México
| | - Isela Esther Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, México
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23
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Childhood maltreatment correlates with higher concentration of transforming growth factor beta (TGF-β) in adult patients with major depressive disorder. Psychiatry Res 2021; 301:113987. [PMID: 34023675 DOI: 10.1016/j.psychres.2021.113987] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 05/04/2021] [Indexed: 12/29/2022]
Abstract
Transforming growth factor beta (TGF-β), which has a role as a regulatory cytokine, has not been widely investigated in patients with major depressive disorder (MDD) who experienced childhood trauma. The aim of our study was to investigate the differences in circulating TGF-β levels between the patients with major depressive disorder (MDD) with and without child maltreatment (CM) history, and to compare them to the corresponding control subjects' groups (with or without CM). Blood samples were obtained from 55 patients, fulfilling DSM-IV-R criteria for a current MDD episode without psychotic symptoms, and 45 healthy controls, matched for age and gender. Participants were administered the Childhood Trauma Questionnaire (CTQ). Serum TGF-β concentration was determined by enzyme-linked immunosorbent assay. The concentration of TGF-β was significantly higher in patients with MDD with CM history, compared to MDD patients with no CM, as well as both control groups. Furthermore, we have shown that the combined effect of CM history and MDD affected TGF-β levels in adulthood, which was not observed in the control group with CM. These results indicate that MDD patients with the experience of CM have altered immune-regulatory response, and they may constitute a specific subtype within this heterogenic disorder (ecophenotype).
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24
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González-Castro TB, Tovilla-Zárate CA, Juárez-Rojop IE, López-Narváez ML, Pérez-Hernández N, Rodríguez-Pérez JM, Genis-Mendoza AD. The role of gene polymorphisms, and analysis of peripheral and central levels of interleukins in suicidal behavior: A systematic review. J Affect Disord 2021; 279:398-411. [PMID: 33099055 DOI: 10.1016/j.jad.2020.10.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 09/10/2020] [Accepted: 10/11/2020] [Indexed: 10/23/2022]
Abstract
In terms of the physiological characteristics of suicidal behavior (SB) disorder, an increase inflammation response has been reported in these individuals. Therefore, the pro-inflammatory and anti-inflammatory activities of interleukins are adequate markers to research in order to understand the pathogenesis of SB. For that reason, the aim of this systematic review was to evaluate the role of interleukins in individuals with suicidal behavior disorder. A systematic search was performed in PubMed, Scopus and EBSCO databases up to July 2019. We used the words "interleukin" AND "suicide", "interleukin" AND "suicidal", and "IL-". Articles where interleukins concentrations were measured in individuals with SB and/or genetic studies addressing interleukins genes variants as possible markers to SB were included. A total of 54 articles were included. Articles that measured interleukin levels comprised 1111 cases and 1588 controls; whereas the genetic studies comprised 3082 cases and 5148 controls. These studies evaluated the concentrations of IL-1β, IL-2, IL-3, IL-4, IL-5, IL-6, IL-8, IL-10, sIL-2R in serum, plasma. The pro-inflammatory interleukins concentrations were higher in cases than in controls; however, we observed heterogeneity in the measurements and sample sources. Whereas, 9 polymorphisms of IL-1α, IL-1β, IL-6, IL-1β-8 genes were analyzed in association with suicide behavior disorder, though no conclusive outcomes were attained. Our results suggest that individuals with suicide risk undergo continuous stress that could trigger the release and circulation of pro-inflammatory interleukins and therefore their concentration in plasma. However, more studies are necessary in order to reach conclusively outcomes.
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Affiliation(s)
| | - Carlos Alfonso Tovilla-Zárate
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Comalcalco, Comalcalco, Tabasco, México..
| | - Isela Esther Juárez-Rojop
- Universidad Juárez Autónoma de Tabasco, División Académica de Ciencias de la Salud, Villahermosa, Tabasco, México.
| | - María Lilia López-Narváez
- Hospital General de Yajalón "Dr. Manuel Velazco Siles", Secretaría de Salud. Yajalón, Chiapas, México..
| | - Nonanzit Pérez-Hernández
- Departamento de Biología Molecular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México..
| | - José Manuel Rodríguez-Pérez
- Departamento de Biología Molecular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México..
| | - Alma Delia Genis-Mendoza
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México, México..
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25
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Chen S, Zhang Y, Yuan Y. The Combination of Serum BDNF, Cortisol and IFN-Gamma Can Assist the Diagnosis of Major Depressive Disorder. Neuropsychiatr Dis Treat 2021; 17:2819-2829. [PMID: 34471356 PMCID: PMC8405229 DOI: 10.2147/ndt.s322078] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/13/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Misdiagnosis and ineffective treatment are common in major depressive disorder (MDD) in current clinical practice, while the combination of various serum proteins may assist the correct diagnosis. The study aimed to explore whether the combination of serum inflammatory, stress, and neurotrophic factors could be helpful for the diagnosis of MDD and to investigate the predictors associated with early symptom improvements. PATIENTS AND METHODS Baseline serum levels of C-reactive protein (CRP), interleukin (IL)-6, IL-10, IL-1beta, tumor necrosis factor (TNF)-alpha, interferon (INF)-gamma, cortisol, and brain-derived neurotrophic factor (BDNF) were detected in 30 MDD patients and 30 age- and gender-matched healthy controls. 17-item Hamilton Depression Rating Scale (HAMD-17) and Hamilton Anxiety Rating Scale (HAMA) were applied to assess symptoms both at baseline and two weeks after antidepressant treatment. Stepwise multiple linear regression was employed to identify the early efficacy predictors, and a logistic regression model was built with the above serum proteins. The area under the receiver operating characteristic (AUC) curve was calculated to evaluate the model's diagnostic power. RESULTS Multiple linear regression revealed that baseline scores of retardation (β = -0.432, P = 0.012) and psychological anxiety (β = -0.423, P = 0.014) factors were negatively associated with the reduction rate of HAMD-17. A simple and efficient diagnostic model using serum BDNF, cortisol, and IFN-gamma levels was established by the forward stepwise logistic regression, and the model achieved an AUC of 0.884, with 86.7% sensitivity and 83.3% specificity. CONCLUSION The results showed that combining serum BDNF, cortisol and IFN-gamma could aid the diagnosis of MDD, while baseline retardation and psychological anxiety may predict the poor early symptom improvement.
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Affiliation(s)
- Suzhen Chen
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, 210009, People's Republic of China.,Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, 210009, People's Republic of China
| | - Yuqun Zhang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210023, People's Republic of China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, 210009, People's Republic of China.,Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, 210009, People's Republic of China
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26
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Coryell W, Wilcox H, Evans SJ, Pandey GN, Jones-Brando L, Dickerson F, Yolken R. Latent infection, inflammatory markers and suicide attempt history in depressive disorders. J Affect Disord 2020; 270:97-101. [PMID: 32339111 DOI: 10.1016/j.jad.2020.03.057] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 06/17/2019] [Accepted: 03/20/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Numerous reports have described increased rates of exposure to Toxoplasma gondii levels in individuals with a history of suicide attempts in comparison with well controls, or psychiatrically ill individuals, with no suicide attempt history. Such findings suggest that the behavioral effects this parasite exerts on rodent hosts extends to humans though few studies have searched for underlying mechanisms. METHODS The present study compared 96 patients with an active depressive disorder and a history of at least two suicide attempts to 126 depressed patients with no history of suicide attempts by IgG and IgM levels of Toxoplasma gondii and cytomegalovirus (CMV). The groups were also compared by IL_1b, TNF-alpha, CRP, IL_6, and IL_1ra titers. RESULTS Toxoplasma gondii IgM levels were higher, and seropositivity more likely, in the suicide attempt group. CMV IgG levels were also higher among suicide attempters. Several of these immunoglobulin measures were more robustly associated with the number of suicide attempts than with the dichotomy of suicide attempter and non-attempter. These two antibody levels were also additive in their association with suicide attempter status. IL_1a levels were lower in suicide attempters and correlated negatively with levels of antibodies to Toxoplasma gondii and CMV. LIMITATIONS These include a sample size insufficient to explore differences across mood disorder diagnoses or demographic groupings. CONCLUSIONS These results indicate that exposure to common infectious agents such as Toxoplasma gondii and CMV are associated with increased risk of suicide attempts but the mechanism of association does not appear to involve the activation of cytokines. Elucidation of the mechanisms which define the relationship between infections and suicide attempts may lead to new methods for the prediction and prevention of suicide attempts.
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Affiliation(s)
- William Coryell
- Psychiatry Research, University of Iowa Carver College of Medicine, 500 Newton Road, 2-205 MEB, Iowa City, IA, 52242-1000, USA.
| | | | | | | | | | | | - Robert Yolken
- Stanley Division of Developmental Neurovirology, USA
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27
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Wang H, Li P, Zhang Y, Zhang C, Li K, Song C. Cytokine changes in different types of depression: Specific or general? ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.npbr.2020.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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28
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Grudet C, Wolkowitz OM, Mellon SH, Malm J, Reus VI, Brundin L, Nier BM, Dhabhar FS, Hough CM, Westrin Å, Lindqvist D. Vitamin D and inflammation in major depressive disorder. J Affect Disord 2020; 267:33-41. [PMID: 32063570 PMCID: PMC10662683 DOI: 10.1016/j.jad.2020.01.168] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 12/06/2019] [Accepted: 01/28/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Increased inflammation is reported in Major Depressive Disorder (MDD), which may be more pronounced in suicidal subjects. Vitamin D deficiency may drive this pro-inflammatory state due to vitamin D's anti-inflammatory effects. METHODS We quantified plasma 25-hydroxyvitamin D (25(OH)D) and inflammatory markers interleukin (IL)-6 and tumor necrosis factor (TNF)-α, and other inflammatory indices, neutrophil-to-lymphocyte ratio (NLR) and white blood cell count (WBC) in 48 un-medicated MDD subjects (n = 17 with mild-to-moderate suicidal ideation [SI]) and 54 controls. IL-6 and TNF-α were combined into a composite inflammation score. RESULTS There were no significant differences in 25(OH)D levels between MDD and controls (p = 0.24) or between MDD with and without SI (p = 0.61). However, 25(OH)D was negatively correlated with all measured inflammatory markers; these correlations were stronger in MDD subjects, and particularly in those with SI. MDD status significantly moderated the relationships between 25(OH)D and NLR (p = 0.03), and 25(OH)D and WBC (p < 0.05), and SI significantly moderated the relationship between 25(OH)D and NLR (p = 0.03). LIMITATIONS The study was cross-sectional, thereby limiting causal inference, and had a small sample size. Only seventeen of the MDD subjects had SI. CONCLUSION While 25(OH)D levels did not significantly differ in MDD vs. controls, or in MDD with or without SI, lower 25(OH)D was associated with indices of immune activation in MDD, especially in cases with SI. Although our findings do not address causality, they are consistent with findings that relatively low 25(OH)D levels in MDD are associated with a pro-inflammatory state.
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Affiliation(s)
- Cécile Grudet
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund, Sweden
| | - Owen M Wolkowitz
- Weill Institute for Neurosciences/ Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Synthia H Mellon
- Department of OB/GYN and Reproductive Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Johan Malm
- Department of Translational Medicine, Section for Clinical Chemistry, Lund University, Malmö, Sweden
| | - Victor I Reus
- Weill Institute for Neurosciences/ Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Lena Brundin
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | - Brenton M Nier
- Weill Institute for Neurosciences/ Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Firdaus S Dhabhar
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, USA
| | - Christina M Hough
- Weill Institute for Neurosciences/ Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA; University of California, Los Angeles (UCLA), Department of Psychology, Los Angeles, CA, USA
| | - Åsa Westrin
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund, Sweden; Office of Psychiatry and Habilitation, Region Skåne, Sweden
| | - Daniel Lindqvist
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund, Sweden; Weill Institute for Neurosciences/ Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA; Office of Psychiatry and Habilitation, Region Skåne, Sweden.
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Lee H, Song M, Lee J, Kim JB, Lee MS. Prospective study on cytokine levels in medication-naïve adolescents with first-episode major depressive disorder. J Affect Disord 2020; 266:57-62. [PMID: 32056928 DOI: 10.1016/j.jad.2020.01.125] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/24/2019] [Accepted: 01/20/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Evidence suggests that depression is correlated with immune-inflammatory responses, and efforts have been made to identify the relationships between depression and inflammatory markers. This study investigated the level of cytokines before and after treatment for major depressive disorder (MDD) in medication-naïve adolescents with first-episode MDD and compared them with the levels in healthy adolescents. The relationship between cytokine levels and the severity of depressive symptoms was also examined. METHODS Twenty-five adolescents with MDD and 25 healthy controls aged 13 to 18 years were included in the study. Blood samples were obtained, and depression severity was assessed twice in the MDD group before and after treatment and once in the healthy group. RESULTS When compared with healthy controls, adolescents with MDD had lower levels of interleukin 2 (IL-2), interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α) and IL-10 before treatment and higher levels of IL-2, IFN-γ, and IL-10 after treatment. In addition, the IFN-γ levels correlated with depressive severity scores in both the Children's Depression Inventory (CDI) and Hamilton Depression Rating Scale (HDRS). The IL-10 level correlated with depressive severity only on the HDRS. LIMITATIONS The sample size was small, and the 12-week follow-up time after treatment was relatively short. CONCLUSION IL-2, IFN-γ, TNF-α, and IL-10 levels in medication-naïve adolescents with first-episode MDD differed from those in healthy controls. The levels of IL-2, IFN-γ, and IL-10 were altered after antidepressant treatment. Further, the IFN-γ and IL-10 levels correlated with the severity of depressive symptoms.
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Affiliation(s)
- Hojun Lee
- Department of Psychiatry, Keimyung University Dongsan Hospital, Daegu, South Korea
| | - Minjae Song
- Department of Child and Adolescent Psychiatry, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul 08308, South Korea
| | - Jongha Lee
- Department of Psychiatry, Korea University Ansan Hospital, Ansan, South Korea
| | - Jung-Bum Kim
- Department of Psychiatry, Keimyung University Dongsan Hospital, Daegu, South Korea
| | - Moon-Soo Lee
- Department of Child and Adolescent Psychiatry, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul 08308, South Korea.
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A Specific Inflammatory Profile Underlying Suicide Risk? Systematic Review of the Main Literature Findings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072393. [PMID: 32244611 PMCID: PMC7177217 DOI: 10.3390/ijerph17072393] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/09/2020] [Accepted: 03/26/2020] [Indexed: 01/15/2023]
Abstract
Consistent evidence indicates the association between inflammatory markers and suicidal behavior. The burden related to immunological differences have been widely documented in both major affective disorders and suicidal behavior. Importantly, abnormally elevated pro-inflammatory cytokines levels have been reported to correlate with suicidal behavior but whether and to what extent specific inflammatory cytokines abnormalities may contribute to our understanding of the complex pathophysiology of suicide is unknown. The present manuscript aimed to systematically review the current literature about the role of pro-inflammatory cytokines in suicidal behavior. Most studies showed a link between abnormally higher interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β1, vascular endothelial growth factor (VEGF), kynurenic acid (KYN), and lower IL-2, IL-4, and interferon (IFN)-γ levels in specific brain regions and suicidal behavior. Unfortunately, most studies are not able to exclude the exact contribution of major depressive disorder (MDD) as a mediator/moderator of the link between inflammatory cytokines abnormalities and suicidal behavior. The association between suicidal patients (both suicide attempters or those with suicidal ideation) and the altered immune system was documented by most studies, but this does not reflect the existence of a specific causal link. Additional studies are needed to clarify the immune pathways underlying suicidal behavior.
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Bialek K, Czarny P, Watala C, Wigner P, Talarowska M, Galecki P, Szemraj J, Sliwinski T. Novel association between TGFA, TGFB1, IRF1, PTGS2 and IKBKB single-nucleotide polymorphisms and occurrence, severity and treatment response of major depressive disorder. PeerJ 2020; 8:e8676. [PMID: 32140313 PMCID: PMC7047865 DOI: 10.7717/peerj.8676] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 02/03/2020] [Indexed: 12/25/2022] Open
Abstract
Background Activation of the immune system might affect the severity of depressive episodes as well as response to the antidepressant treatment. The purpose of this study was to investigate whether the occurrence of variant alleles of analyzed SNPs are involved in prevalence and progression of depression. Moreover, selected genes and SNPs have not been investigated in context of the disease severity and treatment. Therefore, six polymorphisms were selected: g.41354391A>G-TGFB1 (rs1800469), g.132484229C>A-IRF (rs2070729), g.186643058A>G-PTGS2 (rs5275), g.186640617C>T-PTGS2 (rs4648308), g.70677994G>A-TGFA (rs2166975) and g.42140549G>T-IKBKB (rs5029748). Methods A total of 360 (180 patients and 180 controls) DNA samples were genotyped using TaqMan probes. Results We observed that A/G of the rs2166975 TGFA, A/C of rs2070729 IRF1 and G/T of rs5029748 IKBKB were associated with an increased risk of depression development while the T/T of rs5029748 IKBKB, T/T of rs4648308 PTGS2 and G/G of rs2166975 TGFA reduced this risk. We also stratified the study group according to gender and found that genotype A/G and allele G of the rs2166975 TGFA, G/T of rs5029748 IKBKB as well as C allele of rs4648308 PTGS2, homozygote A/A and allele A of rs5275 PTGS2 were associated with increased risk of depression development in men while homozygote G/G of rs5275 PTGS2 decreased this risk. Moreover, C/T of rs4648308 PTGS2 and A/G of rs5275 PTGS2 was positively correlated with the risk of the disease occurrence in women. Furthermore, a gene-gene analysis revealed a link between studied polymorphisms and depression. In addition, A/A of rs1800469 TGFB1 was associated with earlier age of onset of the disease while G/G of this SNP increased severity of the depressive episode. Interestingly, A/C of rs2070729 IRF1 and T/T of rs5029748 IKBKB may modulate the effectiveness of selective serotonin reuptake inhibitors therapy. In conclusion, studied SNPs may modulate the risk of occurrence, age of onset, severity of the disease and response to the antidepressant treatment.
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Affiliation(s)
- Katarzyna Bialek
- Laboratory of Medical Genetics, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - Piotr Czarny
- Department of Medical Biochemistry, Medical University of Lodz, Lodz, Poland
| | - Cezary Watala
- Department of Haemostatic Disorders, Medical University of Lodz, Lodz, Poland
| | - Paulina Wigner
- Laboratory of Medical Genetics, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - Monika Talarowska
- Institute of Psychology, Department of Personality and Individual Differences, University of Lodz, Lodz, Poland
| | - Piotr Galecki
- Department of Adult Psychiatry, Medical University of Lodz, Lodz, Poland
| | - Janusz Szemraj
- Department of Medical Biochemistry, Medical University of Lodz, Lodz, Poland
| | - Tomasz Sliwinski
- Laboratory of Medical Genetics, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
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Jha MK, Cai L, Minhajuddin A, Fatt CC, Furman JL, Gadad BS, Mason BL, Greer TL, Hughes JL, Xiao G, Emslie G, Kennard B, Mayes T, Trivedi MH. Dysfunctional adaptive immune response in adolescents and young adults with suicide behavior. Psychoneuroendocrinology 2020; 111:104487. [PMID: 31756521 DOI: 10.1016/j.psyneuen.2019.104487] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Immune system dysfunction has been implicated in the pathophysiology of suicide behavior. Here, we conducted an exploratory analysis of immune profile differences of three groups of adolescents and young adults (ages 10-25 years): healthy controls (n = 39), at risk of major depressive disorder (MDD; at-risk, n = 33), and MDD with recent suicide behavior/ ideation (suicide behavior, n = 37). METHODS Plasma samples were assayed for chemokines and cytokines using Bio-Plex Pro Human Chemokine 40-plex assay. Log-transformed cytokine and chemokine levels were compared after controlling for age, gender, body mass index, race, ethnicity, and C-reactive protein (CRP) levels. In post-hoc analyses to understand the effect of dysregulated immune markers identified in this exploratory analysis, their association with autoantibodies was tested in an unrelated sample (n = 166). RESULTS Only levels of interleukin 4 (IL-4) differed significantly among the three groups [false discovery rate (FDR) adjusted p = 0.0007]. Participants with suicide behavior had lower IL-4 [median = 16.8 pg/ml, interquartile range (IQR) = 7.9] levels than healthy controls (median = 29.1 pg/ml, IQR = 16.1, effect size [ES] = 1.30) and those at-risk (median = 24.4 pg/ml, IQR = 16.3, ES = 1.03). IL-4 levels were negatively correlated with depression severity (r= -0.38, p = 0.024). In an unrelated sample of outpatients with MDD, levels of IL-4 were negatively correlated (all FDR p < 0.05) with several autoantibodies [54/117 in total and 12/18 against innate immune markers]. CONCLUSIONS Adolescent and young adult patients with recent suicide behavior exhibit lower IL-4 levels. One biological consequence of reduced IL-4 levels may be increased risk of autoimmunity.
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Affiliation(s)
- Manish K Jha
- Center for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, TX, United States; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ling Cai
- Quantitative Biomedical Research Center, Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX, United States
| | - Abu Minhajuddin
- Center for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, TX, United States
| | - Cherise Chin Fatt
- Center for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, TX, United States
| | - Jennifer L Furman
- Center for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, TX, United States
| | - Bharathi S Gadad
- Center for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, TX, United States; Department of Psychiatry, Texas Tech University Health Science Center, El Paso, Texas, United States
| | - Brittany L Mason
- Center for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, TX, United States
| | - Tracy L Greer
- Center for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, TX, United States
| | - Jennifer L Hughes
- Center for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, TX, United States
| | - Guanghua Xiao
- Quantitative Biomedical Research Center, Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX, United States
| | - Graham Emslie
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States
| | - Betsy Kennard
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States
| | - Taryn Mayes
- Center for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, TX, United States
| | - Madhukar H Trivedi
- Center for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, TX, United States.
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Shinko Y, Otsuka I, Okazaki S, Horai T, Boku S, Takahashi M, Ueno Y, Sora I, Hishimoto A. Chemokine alterations in the postmortem brains of suicide completers. J Psychiatr Res 2020; 120:29-33. [PMID: 31629996 DOI: 10.1016/j.jpsychires.2019.10.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/19/2019] [Accepted: 10/09/2019] [Indexed: 10/25/2022]
Abstract
Suicide is a major health problem in the modern world. However, its physiological mechanisms have not been well elucidated yet. Immunological disturbances have been reported in psychiatric disorders such as major depressive disorder (MDD), bipolar disorder (BP), and schizophrenia. Some studies have also suggested an association between immunological alterations especially neuroinflammation, and suicide. Chemokines play important roles in inflammation, and studies investigating chemokines in psychiatric diseases such as schizophrenia, MDD, and BP have reported chemokine dysregulations. However, there have been very few studies on the association between chemokines and suicide. We studied chemokine alterations in the postmortem brains of suicide completers and compared them to those of controls. We obtained brain tissue samples of the dorsolateral prefrontal cortex from 16 suicide completers and 23 controls. We examined the concentrations of chemokines and related substances in the brain tissue from these two groups using the Bio-Plex Pro™ Human Chemokine Panel 40-Plex. We performed multiple regression analysis with covariates. The levels of CCL1, CCL8, CCL13, CCL15, CCL17, CCL19, CCL20, CXCL11, and IL-10 were significantly decreased, whereas the IL-16 levels were significantly increased in the suicide completers after adjustment with the Benjamini-Hochberg method to control for type Ⅰ errors (Q < 0.05). The observed chemokine alterations might suggest the presence of suicide-specific immunological mechanisms.
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Affiliation(s)
- Yutaka Shinko
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ikuo Otsuka
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Satoshi Okazaki
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tadasu Horai
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shuken Boku
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Motonori Takahashi
- Division of Legal Medicine, Department of Community Medicine and Social Health Science, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasuhiro Ueno
- Division of Legal Medicine, Department of Community Medicine and Social Health Science, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ichiro Sora
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan.
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Kim H, Cho SJ, Yoo SH, Kim SH, Ahn YM. Association between telomere length and completed suicide observed in 71 suicide victims - Preliminary findings. J Psychosom Res 2019; 120:8-11. [PMID: 30929712 DOI: 10.1016/j.jpsychores.2019.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 01/08/2019] [Accepted: 02/17/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Telomere length has emerged as a cumulative marker for lifestyle, psychosocial stress, and cytotoxic environments. We aimed to examine the possible association between leukocyte telomere length (LTL) and completed suicide. METHODS This study included 71 suicide completers and 117 healthy controls for whom LTL was determined by the ratio of the telomere repeat copy number to the single-copy gene copy number (T/S ratio). We compared the LTL between the suicide completers and the healthy controls and estimated the odds ratio (OR) for suicide for each age group, applying a generalized estimating equation (GEE). RESULTS LTL was significantly shortened in the suicide completers as compared with the controls, overall subjects, or within-age categories (≤29 and 30-49 years). Furthermore, a longer LTL was associated with significantly decreased odds of completed suicide for those aged ≤29 years and 30-49 years (OR = 0.11, 95% confidence interval [CI] 0.03-0.37, p < .001 for the ≤29-year age group; OR = 0.54, 95% CI 0.34-0.84, p = .006 for the 30- to 49-year age group). CONCLUSIONS This study provides evidence regarding the relationship between shortened LTL and completed suicide, especially in those aged <50 years. Future research should further assess potential confounders and examine underlying mechanisms.
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Affiliation(s)
- Hyeyoung Kim
- Department of Psychiatry, Inha University Hospital, 27 Inhang-ro, Jung-gu, Incheon 22332, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Sung Joon Cho
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Seong Ho Yoo
- Department of Forensic Medicine, Seoul National University College of Medicine,103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Se Hyun Kim
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Yong Min Ahn
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
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Eidan AJ, AL-Harmoosh RA, Al-Amarei HM. Estimation of IL-6, INFγ, and Lipid Profile in Suicidal and Nonsuicidal Adults with Major Depressive Disorder. J Interferon Cytokine Res 2019; 39:181-189. [DOI: 10.1089/jir.2018.0134] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Ali J. Eidan
- Department of Basic Medical Science, Faculty of Nursing, University of Kufa, Najaf, Iraq
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Interleukin-6 and Interleukin-10 in mood disorders: A population-based study. Psychiatry Res 2019; 273:685-689. [PMID: 31207853 DOI: 10.1016/j.psychres.2019.01.100] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The aim of this study was to assess if cytokines levels (IL-6 and IL-10) are related to major depressive disorder (MDD) and bipolar disorder (BD), in a population-based study. METHODS This was a cross-sectional study population-based, involving 1037 people aged 18-35. MDD, BD, anxiety and suicide risk were assessed using the Mini International Neuropsychiatric Interview. Serum IL-6 and IL-10 were measured by ELISA using a commercial kit. RESULTS The total sample comprised 1034 young adults, being 14.4% with MDD and 13.7% with BD. MDD and BD groups showed significantly higher serum IL-6 levels (p ≤ 0.001) and IL-10 levels (p ≤ 0.001) when compared to healthy control group. No correlation was found between serum IL-6 and IL-10 levels in health control group (p = 0.830; r = -0.008), non-suicide risk (p = 0.337; r = 0.032) and non-anxiety disorder (p = 0.375; r = 0.031). Covariance analysis showed that mood disorders alone, increase both interleukin levels (IL-6, p = 0.019; and IL-10, p = 0.026), whilst the interaction of mood disorders and suicide risk or anxiety disorders did not. CONCLUSION Our results suggest that inflammatory dysregulation may be involved in the physiopathology of mood disorders and serum IL-6 and IL-10 levels are putative biomarkers for these disorders.
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Shahar G, Rogers ML, Shalev H, Joiner TE. Self-criticism, interpersonal conditions, and biosystemic inflammation in suicidal thoughts and behaviors within mood disorders: A bio-cognitive-interpersonal hypothesis. J Pers 2018; 88:133-145. [PMID: 30447120 DOI: 10.1111/jopy.12446] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 11/13/2018] [Accepted: 11/14/2018] [Indexed: 12/27/2022]
Abstract
We review the theoretical and empirical literature on the role of self-concept in suicidal behavior in the context of mood disorders (i.e., unipolar depression and bipolar spectrum disorders). The main themes emanating from this review are then juxtaposed against (a) the Interpersonal-Psychological Theory of Suicide and (b) biological research on the role of inflammatory processes in suicidality. Such a juxtaposition paves the way for a bio-cognitive-interpersonal hypothesis. Pathologies of the self-concept-primarily self-criticism-propel mood disorder sufferers to generate interpersonal stress that culminates in two proximal causes of suicidality: thwarted belongingness and perceived burdensomeness. In turn, these two interpersonal conditions set in motion systemic biosystemic inflammation, serving as a proximal cause for suicidality in mood disorders. We conclude by describing a research project aimed at testing this hypothesis, and by outlining pertinent implications for assessment, treatment, and prevention.
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Affiliation(s)
- Golan Shahar
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Megan L Rogers
- Department of Psychology, Florida State University, Tallahassie, Florida
| | - Hadar Shalev
- Department of Psychiatry, Soroka Medical Center, Beer Sheva, Israel
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassie, Florida
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Coryell W, Wilcox H, Evans SJ, Pandey GN, Jones-Brando L, Dickerson F, Yolken R. Aggression, impulsivity and inflammatory markers as risk factors for suicidal behavior. J Psychiatr Res 2018; 106:38-42. [PMID: 30261413 DOI: 10.1016/j.jpsychires.2018.09.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 09/06/2018] [Accepted: 09/06/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Increased inflammatory markers have been linked to suicidal behavior in numerous studies. Measures of aggression and of impulsivity also comprise risks factors for suicidal behavior and there is evidence that inflammatory markers correlate with these traits. The following analyses compare suicide attempters and non-attempters to determine whether inflammatory markers mediate relationships between aggression or impulsivity and proclivities to suicidal behavior. METHODS Investigators at three academic centers recruited patients in major depressive episodes who had a history of two or more suicide attempts (n = 79), or who had no history of suicide attempts (n = 123). Analyses compared these groups by five inflammatory marker levels and by measures of aggression and of impulsivity. RESULTS These results did not confirm the hypotheses that cytokine levels would explain relationships between aggressive behavior and suicide attempt history. However, scores for aggressive behavior and for impulsivity were significantly higher among suicide attempters. One of five of the inflammatory markers, (IL-1β), distinguished the two groups with lower values in the suicide attempt group. IL-1β levels correlated inversely with measures of aggression but neither impulsivity or aggressive behavior appear to explain the association between IL-1β levels and suicide attempt status. CONCLUSION These results identify recent aggressive behavior, higher levels of impulsivity, and lower levels of IL-1β as risk factors for a history of multiple suicide attempts in a group suffering from major depressive episodes. These measures appear to be additive in their effects.
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Affiliation(s)
| | | | | | | | | | | | - Robert Yolken
- Stanley Division of Developmental Neurovirology, USA
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Eftekharian MM, Noroozi R, Omrani MD, Sharifi Z, Komaki A, Taheri M, Ghafouri-Fard S. Single-Nucleotide Polymorphisms in Interleukin 6 (IL-6) Gene Are Associated with Suicide Behavior in an Iranian Population. J Mol Neurosci 2018; 66:414-419. [DOI: 10.1007/s12031-018-1190-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 09/25/2018] [Indexed: 12/18/2022]
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Noroozi R, Omrani MD, Ayatollahi SA, Sayad A, Ata A, Fallah H, Taheri M, Ghafouri-Fard S. Interleukin (IL)-8 polymorphisms contribute in suicide behavior. Cytokine 2018; 111:28-32. [PMID: 30099207 DOI: 10.1016/j.cyto.2018.07.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 02/07/2023]
Abstract
Previous studies have highlighted the role of immune dysregulation in suicide behavior. Interleukin (IL)-8 is a chemokine with neuroprotective effects whose lower serum concentrations have been detected in individuals committed suicide. In the present study, we genotyped three single nucleotide polymorphisms (SNPs) within IL-8 gene (rs4073, rs2227306 and rs1126647) in 229 individuals who attempted suicide with soft suicide methods, 235 suicide victims and 290 individuals without any history of psychiatric disorders or suicide attempt. The T allele of rs4073 was significantly over-represented in suicide attempt group compared with both control and completed suicide groups (adjusted P values of 8.3E-7 and 9.8E-8 respectively). This SNP was associated with suicide attempt in both dominant and co-dominant models (P values of 6.2E-9 and 4.3 E-8 respectively). The genotype and allele frequencies of other SNPs were not significantly different among the three study groups. The T C A haplotype (rs4073, rs2227306 and rs1126647 respectively) were significantly less prevalent in completed suicide group compared with suicide attempt group (OR (95% CI) = 0.63 (0.46-0.86), adjusted P value = 0.03). Besides, the A T A haplotype has significant lower frequency in individuals who attempted soft suicide compared with controls (OR (95% CI) = 0.44 (0.26-0.75), adjusted P value = 0.02). However, this haplotype was significantly more prevalent in individuals attempted hard methods compared with those attempted soft methods (OR (95% CI) = 2.21 (1.26-3.87), adjusted P value = 0.04). The present study provided further evidence for the role of IL-8 in suicide behavior.
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Affiliation(s)
- Rezvan Noroozi
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mir Davood Omrani
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Abdulmajid Ayatollahi
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Chemistry, Richardson College for the Environmental Science Complex, The University of Winnipeg, Winnipeg, MB, Canada
| | - Arezou Sayad
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Athar Ata
- Department of Chemistry, Richardson College for the Environmental Science Complex, The University of Winnipeg, Winnipeg, MB, Canada
| | - Hamid Fallah
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Taheri
- Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Soudeh Ghafouri-Fard
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Tryptophan catabolites along the indoleamine 2,3-dioxygenase pathway as a biological link between depression and cancer. Behav Pharmacol 2018. [DOI: 10.1097/fbp.0000000000000384] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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42
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Kopschina Feltes P, Doorduin J, Klein HC, Juárez-Orozco LE, Dierckx RAJO, Moriguchi-Jeckel CM, de Vries EFJ. Anti-inflammatory treatment for major depressive disorder: implications for patients with an elevated immune profile and non-responders to standard antidepressant therapy. J Psychopharmacol 2017; 31:1149-1165. [PMID: 28653857 PMCID: PMC5606303 DOI: 10.1177/0269881117711708] [Citation(s) in RCA: 166] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Major depressive disorder (MDD) is a prevalent and disabling psychiatric disease with rates of non-responsiveness to antidepressants ranging from 30-50%. Historically, the monoamine depletion hypothesis has dominated the view on the pathophysiology of depression. However, the lack of responsiveness to antidepressants and treatment resistance suggests that additional mechanisms might play a role. Evidence has shown that a subgroup of depressive patients may have an underlying immune deregulation that could explain the lack of therapeutic benefit from antidepressants. Stimuli like inflammation and infection can trigger the activation of microglia to release pro-inflammatory cytokines, acting on two main pathways: (1) activation of the hypothalamic-pituitary adrenal axis, generating an imbalance in the serotonergic and noradrenergic circuits; (2) increased activity of the enzyme indoleamine-2,3-dioxygenase, resulting in depletion of serotonin levels and the production of quinolinic acid. If this hypothesis is proven true, the subgroup of MDD patients with increased levels of pro-inflammatory cytokines, mainly IL-6, TNF-α and IL-1β, might benefit from an anti-inflammatory intervention. Here, we discuss the pre-clinical and clinical studies that have provided support for treatment with non-steroidal anti-inflammatory drugs in depressed patients with inflammatory comorbidities or an elevated immune profile, as well as evidences for anti-inflammatory properties of standard antidepressants.
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Affiliation(s)
- Paula Kopschina Feltes
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, the Netherlands
- Instituto de Geriatria e Gerontologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brasil
| | - Janine Doorduin
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, the Netherlands
| | - Hans C Klein
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, the Netherlands
| | - Luis Eduardo Juárez-Orozco
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, the Netherlands
| | - Rudi AJO Dierckx
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, the Netherlands
| | - Cristina M Moriguchi-Jeckel
- Instituto de Geriatria e Gerontologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brasil
- Instituto do Cérebro do Rio Grande do Sul, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brasil
| | - Erik FJ de Vries
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, the Netherlands
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Niculescu AB, Le-Niculescu H, Levey DF, Phalen PL, Dainton HL, Roseberry K, Niculescu EM, Niezer JO, Williams A, Graham DL, Jones TJ, Venugopal V, Ballew A, Yard M, Gelbart T, Kurian SM, Shekhar A, Schork NJ, Sandusky GE, Salomon DR. Precision medicine for suicidality: from universality to subtypes and personalization. Mol Psychiatry 2017; 22:1250-1273. [PMID: 28809398 PMCID: PMC5582166 DOI: 10.1038/mp.2017.128] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 05/04/2017] [Accepted: 05/08/2017] [Indexed: 01/15/2023]
Abstract
Suicide remains a clear, present and increasing public health problem, despite being a potentially preventable tragedy. Its incidence is particularly high in people with overt or un(der)diagnosed psychiatric disorders. Objective and precise identification of individuals at risk, ways of monitoring response to treatments and novel preventive therapeutics need to be discovered, employed and widely deployed. We sought to investigate whether blood gene expression biomarkers for suicide (that is, a 'liquid biopsy' approach) can be identified that are more universal in nature, working across psychiatric diagnoses and genders, using larger cohorts than in previous studies. Such markers may reflect and/or be a proxy for the core biology of suicide. We were successful in this endeavor, using a comprehensive stepwise approach, leading to a wealth of findings. Steps 1, 2 and 3 were discovery, prioritization and validation for tracking suicidality, resulting in a Top Dozen list of candidate biomarkers comprising the top biomarkers from each step, as well as a larger list of 148 candidate biomarkers that survived Bonferroni correction in the validation step. Step 4 was testing the Top Dozen list and Bonferroni biomarker list for predictive ability for suicidal ideation (SI) and for future hospitalizations for suicidality in independent cohorts, leading to the identification of completely novel predictive biomarkers (such as CLN5 and AK2), as well as reinforcement of ours and others previous findings in the field (such as SLC4A4 and SKA2). Additionally, we examined whether subtypes of suicidality can be identified based on mental state at the time of high SI and identified four potential subtypes: high anxiety, low mood, combined and non-affective (psychotic). Such subtypes may delineate groups of individuals that are more homogenous in terms of suicidality biology and behavior. We also studied a more personalized approach, by psychiatric diagnosis and gender, with a focus on bipolar males, the highest risk group. Such a personalized approach may be more sensitive to gender differences and to the impact of psychiatric co-morbidities and medications. We compared testing the universal biomarkers in everybody versus testing by subtypes versus personalized by gender and diagnosis, and show that the subtype and personalized approaches permit enhanced precision of predictions for different universal biomarkers. In particular, LHFP appears to be a strong predictor for suicidality in males with depression. We also directly examined whether biomarkers discovered using male bipolars only are better predictors in a male bipolar independent cohort than universal biomarkers and show evidence for a possible advantage of personalization. We identified completely novel biomarkers (such as SPTBN1 and C7orf73), and reinforced previously known biomarkers (such as PTEN and SAT1). For diagnostic ability testing purposes, we also examined as predictors phenotypic measures as apps (for suicide risk (CFI-S, Convergent Functional Information for Suicidality) and for anxiety and mood (SASS, Simplified Affective State Scale)) by themselves, as well as in combination with the top biomarkers (the combination being our a priori primary endpoint), to provide context and enhance precision of predictions. We obtained area under the curves of 90% for SI and 77% for future hospitalizations in independent cohorts. Step 5 was to look for mechanistic understanding, starting with examining evidence for the Top Dozen and Bonferroni biomarkers for involvement in other psychiatric and non-psychiatric disorders, as a mechanism for biological predisposition and vulnerability. The biomarkers we identified also provide a window towards understanding the biology of suicide, implicating biological pathways related to neurogenesis, programmed cell death and insulin signaling from the universal biomarkers, as well as mTOR signaling from the male bipolar biomarkers. In particular, HTR2A increase coupled with ARRB1 and GSK3B decreases in expression in suicidality may provide a synergistic mechanistical corrective target, as do SLC4A4 increase coupled with AHCYL1 and AHCYL2 decrease. Step 6 was to move beyond diagnostics and mechanistical risk assessment, towards providing a foundation for personalized therapeutics. Items scored positive in the CFI-S and subtypes identified by SASS in different individuals provide targets for personalized (psycho)therapy. Some individual biomarkers are targets of existing drugs used to treat mood disorders and suicidality (lithium, clozapine and omega-3 fatty acids), providing a means toward pharmacogenomics stratification of patients and monitoring of response to treatment. Such biomarkers merit evaluation in clinical trials. Bioinformatics drug repurposing analyses with the gene expression biosignatures of the Top Dozen and Bonferroni-validated universal biomarkers identified novel potential therapeutics for suicidality, such as ebselen (a lithium mimetic), piracetam (a nootropic), chlorogenic acid (a polyphenol) and metformin (an antidiabetic and possible longevity promoting drug). Finally, based on the totality of our data and of the evidence in the field to date, a convergent functional evidence score prioritizing biomarkers that have all around evidence (track suicidality, predict it, are reflective of biological predisposition and are potential drug targets) brought to the fore APOE and IL6 from among the universal biomarkers, suggesting an inflammatory/accelerated aging component that may be a targetable common denominator.
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Affiliation(s)
- A B Niculescu
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA,Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA,Indianapolis VA Medical Center, Indianapolis, IN, USA,INBRAIN, Indiana University School of Medicine, Indianapolis, IN, USA,Department of Psychiatry, Indiana University School of Medicine, Neuroscience Research Building 200B, 320 West 15th Street, Indianapolis, IN 46202, USA. E-mail:
| | - H Le-Niculescu
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - D F Levey
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA,Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - P L Phalen
- Indianapolis VA Medical Center, Indianapolis, IN, USA
| | - H L Dainton
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - K Roseberry
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - E M Niculescu
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - J O Niezer
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A Williams
- Indianapolis VA Medical Center, Indianapolis, IN, USA
| | - D L Graham
- Indianapolis VA Medical Center, Indianapolis, IN, USA
| | - T J Jones
- Indianapolis VA Medical Center, Indianapolis, IN, USA
| | - V Venugopal
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A Ballew
- Marion County Coroner’s Office, Indianapolis, IN, USA
| | - M Yard
- INBRAIN, Indiana University School of Medicine, Indianapolis, IN, USA
| | - T Gelbart
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | - S M Kurian
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | - A Shekhar
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - N J Schork
- J. Craig Venter Institute, La Jolla, CA, USA
| | - G E Sandusky
- INBRAIN, Indiana University School of Medicine, Indianapolis, IN, USA
| | - D R Salomon
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA, USA
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Abstract
PURPOSE We aimed to systematically review recent publications (01/2014-03/2017) with longitudinal designs allowing for the assessment of the prospective risk of insomnia on new onset mental illness in key conditions: anxiety, depression, bipolar disorder, posttraumatic stress disorder, substance use disorders, and suicide. RECENT FINDINGS A literature yielded 1859 unique articles meeting search criteria were identified; 16 articles met all selection criteria and reviewed with some studies reporting on more than one mental health outcome. Overall, the review supports the hypothesis that insomnia is a predictor of subsequent mental illness. The evidence is strongest for an insomnia-depression relationship. The new studies identified and reviewed add to a modest number of publications supporting a prospective role of insomnia in new onset mental illness in three areas: anxiety disorders, bipolar disorder, and suicide. The few selected new studies focused on SUD were mixed, and no studies focused on PTSD were identified that met the selection criteria. Treatment of insomnia may also be a preventive mental health strategy.
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Jeenger J, Sharma M, Mathur DM, Amandeep. Associations of number and severity of depressive episodes with C-reactive protein and Interleukin-6. Asian J Psychiatr 2017; 27:71-75. [PMID: 28558901 DOI: 10.1016/j.ajp.2017.02.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 02/09/2017] [Accepted: 02/16/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Many researchers have found that the inflammatory process in the body and the brain may result in psychiatric disorders. Meta-analyses of cross-sectional studies have reported increase in inflammatory markers in depression. However, the direction of the association remains unclear. AIMS To compare the levels of C-reactive protein (CRP) and Interleukin-6 (IL-6) in depressed and healthy controls. To study the associations of these biomarkers with severity and number of depressive episodes. METHODS A total of 72 subjects with major depression and 60 healthy controls were studied. CRP and IL-6 were measured in all subjects. RESULTS No significant differences were noted between depressed patients and healthy controls with regard to CRP (p=0.29) and IL-6 (p=0.50). Those who were suffering from severe depression based on Beck's Depressive Inventory (BDI), were positively correlated with raised CRP (p=0.011) in comparison to patients with mild to moderate depression. Single and recurrent depressive disorder (RDD) were not associated with significant rise in CRP (p=0.866) and IL-6 (p=0.531). CONCLUSIONS Severity of depression is correlated with elevated CRP but not with IL-6. No association found between number of depressive episodes and levels of CRP and IL-6. It is possible that immune dysregulation is not generally present in depression, but might be restricted to particular subgroups of depressed patients. Several factors that could influence the depression and inflammation relationship need further investigation.
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Affiliation(s)
- Jitendra Jeenger
- Department of Psychiatry, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.
| | - Manu Sharma
- Department of Psychiatry, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.
| | - Devendra Mohan Mathur
- Department of Psychiatry, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.
| | - Amandeep
- Department of Psychiatry, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.
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Zadka Ł, Dzięgiel P, Kulus M, Olajossy M. Clinical Phenotype of Depression Affects Interleukin-6 Synthesis. J Interferon Cytokine Res 2017; 37:231-245. [PMID: 28418766 DOI: 10.1089/jir.2016.0074] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Major depressive disorder (MDD) is not a single disease, but a number of various ailments that form one entity. Psychomotor retardation, anhedonia, sleep disorders, an increased suicide risk, and anxiety are the main symptoms that often define the clinical diagnosis of depression. Interleukin-6 (IL-6), as one of the proinflammatory cytokines, seems to be overexpressed during certain mental disorders, including MDD. Overexpression of IL-6 in depression is thought to be a factor associated with bad prognosis and worse disease course. IL-6 may directly affect brain functioning and production of neurotransmitters; moreover, its concentration is correlated with certain clinical symptoms within the wide range of depressive symptomatology. Furthermore, there is a strong correlation between IL-6 synthesis and psychosomatic functioning of the patient. This article discusses potential sources and significance of IL-6 in the pathogenesis of depression.
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Affiliation(s)
- Łukasz Zadka
- 1 Department of Histology and Embryology, Wroclaw Medical University , Wrocław, Poland .,2 II Department of Psychiatry and Psychiatric Rehabilitation, Independent Public Teaching Hospital No 1 in Lublin, Medical University of Lublin , Lublin, Poland
| | - Piotr Dzięgiel
- 1 Department of Histology and Embryology, Wroclaw Medical University , Wrocław, Poland
| | - Michał Kulus
- 1 Department of Histology and Embryology, Wroclaw Medical University , Wrocław, Poland
| | - Marcin Olajossy
- 2 II Department of Psychiatry and Psychiatric Rehabilitation, Independent Public Teaching Hospital No 1 in Lublin, Medical University of Lublin , Lublin, Poland
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Brundin L, Bryleva EY, Thirtamara Rajamani K. Role of Inflammation in Suicide: From Mechanisms to Treatment. Neuropsychopharmacology 2017; 42:271-283. [PMID: 27377015 PMCID: PMC5143480 DOI: 10.1038/npp.2016.116] [Citation(s) in RCA: 147] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 05/31/2016] [Accepted: 06/28/2016] [Indexed: 01/01/2023]
Abstract
Suicidal behavior is complex and manifests because of a confluence of diverse factors. One such factor involves dysregulation of the immune system, which has been linked to the pathophysiology of suicidal behavior. This review will provide a brief description of suicidality and discuss the contribution of upstream and downstream factors in the etiology of suicidal behavior, within the contextual framework of inflammation. The contribution of inflammatory conditions such as traumatic brain injury, autoimmune disorders, and infections to neuropsychiatric symptoms and suicidality is only beginning to be explored. We will summarize studies of inflammation in the etiology of suicide, and provide a neurobiological basis for different mechanisms by which inflammation might contribute to the pathophysiology. Finally, we will review treatments that affect upstream and downstream pathways related to inflammation in suicidality.
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Affiliation(s)
- Lena Brundin
- Laboratory of Behavioral Medicine, Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA
| | - Elena Y Bryleva
- Laboratory of Behavioral Medicine, Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA
| | - Keerthi Thirtamara Rajamani
- Laboratory of Behavioral Medicine, Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA,Department of Behavioral Medicine, Laboratory of Behavioral Medicine, Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI 49503, USA, Tel:+1 616 234 5321, Fax: +1 616 234 5180, E-mail:
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Marini S, Vellante F, Matarazzo I, De Berardis D, Serroni N, Gianfelice D, Olivieri L, Di Renzo F, Di Marco A, Fornaro M, Orsolini L, Valchera A, Iasevoli F, Mazza M, Perna G, Martinotti G, Di Giannantonio M. Inflammatory markers and suicidal attempts in depressed patients: A review. Int J Immunopathol Pharmacol 2016; 29:583-594. [PMID: 26729403 PMCID: PMC5806831 DOI: 10.1177/0394632015623793] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 11/27/2015] [Indexed: 01/01/2023] Open
Abstract
Major depressive disorder is a chronic and invalidating psychiatric illness and is associated with a greater risk of suicidal behaviors. In recent decades many data have supported a biological link between depressive states and inflammation. Pro-inflammatory cytokines have been found to rise, first of all TNF-α and IL-6. Suicidal behaviors have been consistently associated with increased levels of IL-6 and decreased levels of IL-2. The aim of this review is to investigate the relationship between inflammatory markers in depressed patients with or without suicidal attempts compared to healthy controls.
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Affiliation(s)
- Stefano Marini
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Federica Vellante
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Ilaria Matarazzo
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Domenico De Berardis
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4 Teramo, Italy
| | - Nicola Serroni
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4 Teramo, Italy
| | - Daniela Gianfelice
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4 Teramo, Italy
| | - Luigi Olivieri
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4 Teramo, Italy
| | - Fulvia Di Renzo
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4 Teramo, Italy
| | - Anna Di Marco
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4 Teramo, Italy
| | - Michele Fornaro
- Department of "Scienze della Formazione", University of Catania, Italy
| | - Laura Orsolini
- United Hospitals, Academic Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts, UK
| | | | - Felice Iasevoli
- Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy
| | - Monica Mazza
- Department of Health Science, University of L'Aquila, L'Aquila, Italy
| | - Giampaolo Perna
- Hermanas Hospitalarias, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, Como, Italy
- Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, Florida, USA
- Department of Psychiatry and Neuropsychology, University of Maastricht, The Netherlands
| | - Giovanni Martinotti
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
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Courtet P, Giner L, Seneque M, Guillaume S, Olie E, Ducasse D. Neuroinflammation in suicide: Toward a comprehensive model. World J Biol Psychiatry 2016. [PMID: 26223957 DOI: 10.3109/15622975.2015.1054879] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Suicidal behaviour (SB) entered the DSM-5, underlying a specific biological vulnerability. Then, recent findings suggested a possible role of the immune system in SB pathogenesis. The objective of this review is to present these main immune factors involved in SB pathogenesis. METHODS We conducted a review using Preferred Reporting Items for Systematic reviews and Meta-Analysis criteria, and combined ("Inflammation") AND ("Suicidal ideation" OR "Suicidal attempt" OR "suicide"). RESULTS Post mortem studies demonstrated associations between suicide and inflammatory cytokines in the orbitofrontal cortex, a brain region involved in suicidal vulnerability. Also, microgliosis and monocyte-macrophage system activation may be a useful marker of suicide neurobiology. Kynurenine may influence inflammatory processes, and related molecular pathways may be involved in SB pathophysiology. Few recent studies associated inflammatory markers with suicidal vulnerability: serotonin dysfunction, impulsivity and childhood trauma. Interestingly, the perception of threat that leads suicidal individuals to contemplate suicide may activate biological stress responses, including inflammatory responses. CONCLUSIONS Translational projects would be crucial to identify a specific marker in SB disorders, to investigate its clinical correlations, and the interaction between inflammatory cytokines and monoamine systems in SB. These researches might lead to new biomarkers and novel directions for therapeutic strategies.
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Affiliation(s)
- Philippe Courtet
- a Department of Emergency Psychiatry , Hôpital Lapeyronie, CHU Montpellier and Post Acute Care , CHU Montpellier , France.,b Inserm, University of Montpellier , Montpellier , France.,c FondaMental Foundation , France
| | | | - Maude Seneque
- a Department of Emergency Psychiatry , Hôpital Lapeyronie, CHU Montpellier and Post Acute Care , CHU Montpellier , France.,b Inserm, University of Montpellier , Montpellier , France.,c FondaMental Foundation , France
| | - Sebastien Guillaume
- a Department of Emergency Psychiatry , Hôpital Lapeyronie, CHU Montpellier and Post Acute Care , CHU Montpellier , France.,b Inserm, University of Montpellier , Montpellier , France.,c FondaMental Foundation , France
| | - Emilie Olie
- a Department of Emergency Psychiatry , Hôpital Lapeyronie, CHU Montpellier and Post Acute Care , CHU Montpellier , France.,b Inserm, University of Montpellier , Montpellier , France.,c FondaMental Foundation , France
| | - Deborah Ducasse
- a Department of Emergency Psychiatry , Hôpital Lapeyronie, CHU Montpellier and Post Acute Care , CHU Montpellier , France.,b Inserm, University of Montpellier , Montpellier , France.,c FondaMental Foundation , France
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50
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Davami MH, Baharlou R, Ahmadi Vasmehjani A, Ghanizadeh A, Keshtkar M, Dezhkam I, Atashzar MR. Elevated IL-17 and TGF-β Serum Levels: A Positive Correlation between T-helper 17 Cell-Related Pro-Inflammatory Responses with Major Depressive Disorder. Basic Clin Neurosci 2016; 7:137-42. [PMID: 27303608 PMCID: PMC4892318 DOI: 10.15412/j.bcn.03070207] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Introduction: Depression is a mental disorder that highly associated with immune system. Therefore, this study compares the serum concentrations of IL-21, IL-17, and transforming growth factor β (TGF-β) between patients with major depressive disorder and healthy controls. Methods: Blood samples were collected from 41 patients with major depressive disorder and 40 healthy age-matched controls with no history of malignancies or autoimmune disorders. The subjects were interviewed face to face according to DSM-IV diagnostic criteria. Depression score was measured using completed Beck Depression Inventory in both groups. The serum concentrations of IL-21, IL-17, and TGF-β were assessed using ELISA. Results: The mean score of Beck Depression score in the patient and control groups was 35.4±5.5 and 11.1±2.3. IL-17 serum concentrations in the patients and the control group were 10.03±0.6 and 7.6±0.6 pg/mL, respectively (P=0.0002). TGF-β level in the patients group was significantly higher than compare to the control group; 336.7±20.19 vs. 174.8±27.20 pg/mL, (P<0.0001). However, the level of IL-21 was not statistically different between the two groups 84.30±4.57 vs. 84.12±4.15 pg/mL (P>0.05). Conclusion: Considering pro-inflammatory cytokines, current results support the association of inflammatory response and depressive disorder. So, it seems that pro-inflammatory factors profile can be used as indicator in following of depression progress and its treatment impacts.
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Affiliation(s)
- Mohammad Hasan Davami
- Department of Immunology and Microbiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Rasoul Baharlou
- Department of Immunology and Microbiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Abbas Ahmadi Vasmehjani
- Department of Immunology and Microbiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Ahmad Ghanizadeh
- Department of Psychiatry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mitra Keshtkar
- Department of Psychiatry, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Iman Dezhkam
- Department of Student Research Committee, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Mohammad Reza Atashzar
- Department of Immunology and Microbiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
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