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Chan YL, Ho CSH, Tay GWN, Tan TWK, Tang TB. MicroRNA classification and discovery for major depressive disorder diagnosis: Towards a robust and interpretable machine learning approach. J Affect Disord 2024; 360:326-335. [PMID: 38788856 DOI: 10.1016/j.jad.2024.05.066] [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: 02/08/2024] [Revised: 04/08/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Major depressive disorder (MDD) is notably underdiagnosed and undertreated due to its complex nature and subjective diagnostic methods. Biomarker identification would help provide a clearer understanding of MDD aetiology. Although machine learning (ML) has been implemented in previous studies to study the alteration of microRNA (miRNA) levels in MDD cases, clinical translation has not been feasible due to the lack of interpretability (i.e. too many miRNAs for consideration) and stability. METHODS This study applied logistic regression (LR) model to the blood miRNA expression profile to differentiate patients with MDD (n = 60) from healthy controls (HCs, n = 60). Embedded (L1-regularised logistic regression) feature selector was utilised to extract clinically relevant miRNAs, and optimized for clinical application. RESULTS Patients with MDD could be differentiated from HCs with the area under the receiver operating characteristic curve (AUC) of 0.81 on testing data when all available miRNAs were considered (which served as a benchmark). Our LR model selected miRNAs up to 5 (known as LR-5 model) emerged as the best model because it achieved a moderate classification ability (AUC = 0.75), relatively high interpretability (feature number = 5) and stability (ϕ̂Z=0.55) compared to the benchmark. The top-ranking miRNAs identified by our model have demonstrated associations with MDD pathways involving cytokine signalling in the immune system, the reelin signalling pathway, programmed cell death and cellular responses to stress. CONCLUSION The LR-5 model, which is optimised based on ML design factors, may lead to a robust and clinically usable MDD diagnostic tool.
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Affiliation(s)
- Yee Ling Chan
- Centre for Intelligent Signal and Imaging Research (CISIR), Universiti Teknologi PETRONAS (UTP), Bandar Seri Iskandar 32610, Perak, Malaysia
| | - Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117543, Singapore
| | - Gabrielle W N Tay
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117543, Singapore
| | - Trevor W K Tan
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117543, Singapore; Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117543, Singapore; Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117583, Singapore; N.1 Institute for Health & Institute for Digital Medicine (WisDM), National University of Singapore, Singapore 117456, Singapore; Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore 119077, Singapore
| | - Tong Boon Tang
- Centre for Intelligent Signal and Imaging Research (CISIR), Universiti Teknologi PETRONAS (UTP), Bandar Seri Iskandar 32610, Perak, Malaysia.
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Ahmed T, Qassem M, Kyriacou PA. Measuring stress: a review of the current cortisol and dehydroepiandrosterone (DHEA) measurement techniques and considerations for the future of mental health monitoring. Stress 2023; 26:29-42. [PMID: 36625303 DOI: 10.1080/10253890.2022.2164187] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Psychological stress and its inevitable trajectory toward mental health deteriorations such as clinical and major depression has become an unprecedented global burden. The diagnostic procedures involved in the characterization of mental illnesses commonly follow qualitative and subjective measures of stress, often leading to greater socioeconomic burdens due to misdiagnosis and poor understanding of the severity of such illnesses, further fueled by the stigmatization surrounding mental health. In recent years, the application of cortisol and stress hormone measurements has given rise to an alternative, quantifiable approach for the psychological evaluation of stress and depression. This review comprehensively evaluates the current state-of-the-art technology for measuring cortisol and dehydroepiandrosterone (DHEA) and their applications within stress monitoring in humans. Recent advancements in these fields have shown the importance of measuring stress hormones for the characterization of stress manifestation within the human body, and its relevance in mental health decline. Preliminary results from studies considering multimodal approaches toward stress monitoring have showcased promising developments, emphasizing the need for further technological advancement in this field, which consider both neurochemical and physiological biomarkers of stress, for global benefit.
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Affiliation(s)
- Tashfia Ahmed
- Research Centre of Biomedical Engineering, University of London, London, UK
| | - Meha Qassem
- Research Centre of Biomedical Engineering, University of London, London, UK
| | - Panicos A Kyriacou
- Research Centre of Biomedical Engineering, University of London, London, UK
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3
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Yao H, Yang H, Wang Y, Xing Q, Yan L, Chai Y. Gut microbiome and fecal metabolic alteration in systemic lupus erythematosus patients with depression. Front Cell Infect Microbiol 2022; 12:1040211. [PMID: 36506019 PMCID: PMC9732533 DOI: 10.3389/fcimb.2022.1040211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/07/2022] [Indexed: 11/26/2022] Open
Abstract
Background Mental health disorders in systemic lupus erythematosus (SLE) are gradually getting recognized; however, less is known regarding the actual structure and compositional alterations in gut microbiome and metabolism and the mechanisms of how they affect depression development in SLE patients. Methods Twenty-one SLE patients with depression (SLE-d), 17 SLE patients without depression (SLE-nd), and 32 healthy controls (HC) were included in this study. Fecal samples were collected for 16S rRNA gene sequencing and ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-QTOF-MS) based metabolomics. Results The structure of gut microbiome in the SLE-d group changed compared with that in the other two groups. The microbiome composition of SLE-d group showed decreased species richness indices, characterized by low ACE and Chao1 indices, a decrease in the ratio of phylum Firmicutes to Bacteroidetes, genus Faecalibacterium and Roseburia. A downregulation of the metabolite fexofenadine involved in bile secretion was positively correlated with the genus Faecalibacterium, Subdoligranulum and Agathobacter. Compared with the SLE-nd group, the SLE-d group had elevated serum levels of IL-2 and IL-6 and decreased BDNF. Interestingly, abundance of the genus Faecalibacterium and Roseburia was negatively correlated with IL-6, abundance of the genus Roseburia was negatively correlated with IL-2, and abundance of the genus Bacteroides was positively correlated with IL-2. Conclusion This study identified specific fecal microbes and their metabolites that may participate in the development of SLE-d. Our findings provide a new perspective for improving depression in SLE patients by regulating the gut-brain axis.
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Affiliation(s)
- Han Yao
- Department of Immunology and Rheumatology, Qingdao Municipal Hospital Affiliated to Qingdao University, Qingdao, Shandong, China
| | - Hao Yang
- School of Clinical Medicine, Weifang Medical University, Weifang, Shandong, China
| | - Yueying Wang
- Department of Immunology and Rheumatology, Qingdao Municipal Hospital Affiliated to Qingdao University, Qingdao, Shandong, China
| | - Qian Xing
- Department of Immunology and Rheumatology, Qingdao Municipal Hospital Affiliated to Qingdao University, Qingdao, Shandong, China,*Correspondence: Qian Xing,
| | - Lin Yan
- School of Clinical Medicine, Graduate School of Dalian Medical University, Dalian, Liaoning, China
| | - Yaru Chai
- School of Clinical Medicine, Weifang Medical University, Weifang, Shandong, China
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Pombeiro I, Moura J, Pereira MG, Carvalho E. Stress-Reducing Psychological Interventions as Adjuvant Therapies for Diabetic Chronic Wounds. Curr Diabetes Rev 2022; 18:e060821195361. [PMID: 34365927 DOI: 10.2174/1573399817666210806112813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 05/29/2021] [Accepted: 06/04/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetic foot ulcers (DFUs) are a major complication of diabetes mellitus and a leading cause of lower limb amputation. Interventions to reduce psychological stress may have the potential to improve self-care and greatly reduce the morbidity and mortality associated with DFU. This review is focused on the consequences of psychological stress in wound healing and reflects on the effects of currently used psychological stress-reducing interventions in patients with DFU, proposing new applications for currently used stress-reduction interventions. RESULTS Stress is a natural and fundamental survival mechanism that becomes harmful when chronic. DFU is associated with high levels of anxiety and chronic psychological stress. Chronic stressinduced cortisol and adrenaline release impair wound healing, independently of the stressor. Psychological stress-reducing interventions, such as relaxation with guided imagery, biofeedback-assisted relaxation, mindfulness-based strategies, and hypnosis, can lead to a reduction in perceived stress and improve wound healing by reducing wound inflammation and pain while improving glycemic control. All stress reduction interventions also lead to pain relief and improved patient's quality of life. CONCLUSION Psychological stress-reducing interventions are promising adjuvant therapies for DFU. Their clinical application can improve self-care by tackling patient's expectations, anxieties, and fears. They can also help patients manage stress and pain while reducing wound inflammation and improving wound healing.
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Affiliation(s)
- Isadora Pombeiro
- Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - João Moura
- Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - M Graça Pereira
- School of Psychology, Department of Applied Psychology, University of Minho, Braga, Portugal
- Psychology Research Center (CIPsi), University of Minho, Braga, Portugal
| | - Eugénia Carvalho
- Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
- Institute of Interdisciplinary Research, University of Coimbra, Coimbra, Portugal
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Fernandes BM, Scotti-Muzzi E, Soeiro-de-Souza MG. Effects of antidepressant drug therapy with or without physical exercise on inflammatory biomarkers in major depressive disorder: a systematic review and meta-analysis of randomized controlled trials. Eur J Clin Pharmacol 2021; 78:339-349. [PMID: 34708271 DOI: 10.1007/s00228-021-03240-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 10/19/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis of the effects of antidepressant drug therapy (with or without physical exercise) on peripheral inflammatory markers in patients with major depressive disorder (MDD). METHODS MEDLINE, PyscINFO, Embase, and Google Scholar databases were searched until May 2020. Randomized trials that measured at least one inflammatory biomarker and included adult outpatients with MDD under antidepressant drug therapy (any drug) with or without physical exercise (any modality) were eligible. Results were summarized using the standardized mean difference (SMD) with 95% confidence intervals (95% CI) under a random-effects model. The Cochrane risk of bias tool (2010) was used to evaluate the risk of bias in the included trials. RESULTS Sixty-three trials were identified, encompassing data from 3482 patients, and 20 investigated biomarkers. Trials had biases across multiple domains, rising concerns primarily to selection bias/performance bias/detection bias/attrition bias. SMDs between pre- and post-results indicated a significant reduction in the levels of IL-2 (SMD, - 0.25; 95% CI, - 0.41 to - 0.09, P = 0.002), IL-6 (SMD, - 0.19; 95% CI, - 0.35 to - 0.025, P = 0.024), IL-10 (SMD, - 0.32; 95% CI, - 0.57 to - 0.07, P = 0.011), and serum cortisol (SMD, - 0.35; 95% CI, - 0.58 to - 0.12, P = 0.002). Evidence supporting the influence of physical exercise combined with antidepressant drugs on peripheral inflammatory markers in MDD is sparse and heterogeneous. CONCLUSION There is some evidence that antidepressant drug therapy is associated with an overall positive reduction in inflammatory markers, but the evidence is heterogeneous. Further research linking how inflammatory biomarkers modulate physiology related to antidepressant response is required. TRIAL REGISTRATION CRD42020220735.
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Affiliation(s)
- Beatriz Monteiro Fernandes
- Department and Institute of Psychiatry, Hospital das Cllínicas, School of Medicine, University of São Paulo (IPq HC-FMUSP), Dr. Ovidio Pires de Campos s/n, São Paulo, 05403-010, Brazil.
| | - Estêvão Scotti-Muzzi
- Department and Institute of Psychiatry, Hospital das Cllínicas, School of Medicine, University of São Paulo (IPq HC-FMUSP), Dr. Ovidio Pires de Campos s/n, São Paulo, 05403-010, Brazil
| | - Márcio Gerhardt Soeiro-de-Souza
- Department and Institute of Psychiatry, Hospital das Cllínicas, School of Medicine, University of São Paulo (IPq HC-FMUSP), Dr. Ovidio Pires de Campos s/n, São Paulo, 05403-010, Brazil
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Li H, Li Y, Zhang X, Ren G, Wang L, Li J, Wang M, Ren T, Zhao Y, Yang M, Huang X. The Combination of Aquilaria sinensis (Lour.) Gilg and Aucklandia costus Falc. Volatile Oils Exerts Antidepressant Effects in a CUMS-Induced Rat Model by Regulating the HPA Axis and Levels of Neurotransmitters. Front Pharmacol 2021; 11:614413. [PMID: 33716727 PMCID: PMC7943885 DOI: 10.3389/fphar.2020.614413] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/31/2020] [Indexed: 12/17/2022] Open
Abstract
The Aquilaria sinensis (Lour.) Gilg (CX)-Aucklandia costus Falc. (MX) herbal pair is frequently used in traditional Chinese medicine prescriptions for treating depression. The volatile oil from CX and MX has been shown to have good pharmacological activities on the central nervous system, but its curative effect and mechanism in the treatment of depression are unclear. Therefore, the antidepressant effect of the volatile oil from CX-MX (CMVO) was studied in chronic unpredictable mild stress (CUMS) rats. The suppressive effects of CMVO (25, 50, 100 μL/kg) against CUMS-induced depression-like behavior were evaluated using the forced swimming test (FST), open field test (OFT) and sucrose preference test (SPT). The results showed that CMVO exhibited an antidepressant effect, reversed the decreased sugar preference in the SPT and prolongation of immobility time in the FST induced by CUMS, increased the average speed, time to enter the central area, total moving distance, and enhanced the willingness of rats to explore the environment in the OFT. Inhalational administration of CMVO decreased levels of adrenocorticotropic hormone and corticosterone in serum and the expression of corticotropin-releasing hormone mRNA in the hypothalamus, which indicated regulation of over-activation of the hypothalamic-pituitary-adrenal (HPA) axis. In addition, CMVO restored levels of 5-hydroxytryptamine (5-HT), dopamine, norepinephrine and acetylcholine in the hippocampus. The RT-PCR and immunohistochemistry results showed that CMVO up-regulated the expression of 5-HT1A mRNA. This study demonstrated the antidepressant effect of CMVO in CUMS rats, which was possibly mediated via modulation of monoamine and cholinergic neurotransmitters and regulation of the HPA axis.
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Affiliation(s)
- Huiting Li
- College of Pharmacy, Chengdu University of traditional Chinese Medicine, Chengdu, China
| | - Yuanhui Li
- Ministry of Education, Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Xiaofei Zhang
- College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Guilin Ren
- Southwest Medical University Affiliated Hospital of Traditional Chinese Medicine, Luzhou, China
| | - Liangfeng Wang
- Ministry of Education, Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Jianzhe Li
- Ministry of Education, Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Mengxue Wang
- Ministry of Education, Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Tao Ren
- Ministry of Education, Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Yi Zhao
- College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Ming Yang
- College of Pharmacy, Chengdu University of traditional Chinese Medicine, Chengdu, China.,Ministry of Education, Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Xiaoying Huang
- Ministry of Education, Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
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Rothe N, Steffen J, Penz M, Kirschbaum C, Walther A. Examination of peripheral basal and reactive cortisol levels in major depressive disorder and the burnout syndrome: A systematic review. Neurosci Biobehav Rev 2020; 114:232-270. [DOI: 10.1016/j.neubiorev.2020.02.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/27/2020] [Accepted: 02/19/2020] [Indexed: 12/15/2022]
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Osimo EF, Pillinger T, Rodriguez IM, Khandaker GM, Pariante CM, Howes OD. Inflammatory markers in depression: A meta-analysis of mean differences and variability in 5,166 patients and 5,083 controls. Brain Behav Immun 2020; 87:901-909. [PMID: 32113908 PMCID: PMC7327519 DOI: 10.1016/j.bbi.2020.02.010] [Citation(s) in RCA: 370] [Impact Index Per Article: 92.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 01/30/2020] [Accepted: 02/20/2020] [Indexed: 12/27/2022] Open
Abstract
IMPORTANCE The magnitude and variability of cytokine alterations in depression are not clear. OBJECTIVE To perform an up to date meta-analysis of mean differences of immune markers in depression, and to quantify and test for evidence of heterogeneity in immune markers in depression by conducting a meta-analysis of variability to ascertain whether only a sub-group of patients with depression show evidence of inflammation. DATA SOURCES Studies that reported immune marker levels in peripheral blood in patients with depression and matched healthy controls in the MEDLINE database from inception to August 29th 2018 were examined. STUDY SELECTION Case-control studies that reported immune marker levels in peripheral blood in patients with depression and healthy controls were selected. DATA EXTRACTION AND SYNTHESIS Means and variances (SDs) were extracted for each measure to calculate effect sizes, which were combined using multivariate meta-analysis. MAIN OUTCOMES AND MEASURES Hedges g was used to quantify mean differences. Relative variability of immune marker measurements in patients compared with control groups as indexed by the coefficient of variation ratio (CVR). RESULTS A total of 107 studies that reported measurements from 5,166 patients with depression and 5,083 controls were included in the analyses. Levels of CRP (g = 0.71; 95%CI: 0.50-0.92; p < 0.0001); IL-3 (g = 0.60; 95%CI: 0.31-0.89; p < 0.0001); IL-6 (g = 0.61; 95%CI: 0.39-0.82; p < 0.0001); IL-12 (g = 1.18; 95%CI: 0.74-1.62; p < 0.0001); IL-18 (g = 1.97; 95%CI: 1.00-2.95; p < 0.0001); sIL-2R (g = 0.71; 95%CI: 0.44-0.98; p < 0.0001); and TNFα (g = 0.54; 95%CI: 0.32-0.76; p < 0.0001) were significantly higher in patients with depression. These findings were robust to a range of potential confounds and moderators. Mean-scaled variability, measured as CVR, was significantly lower in patients with depression for CRP (CVR = 0.85; 95%CI: 0.75-0.98; p = 0.02); IL-12 (CVR = 0.61; 95%CI: 0.46-0.80; p < 0.01); and sIL-2R (CVR = 0.85; 95%CI: 0.73-0.99; p = 0.04), while it was unchanged for IL-3, IL-6, IL-18, and TNF α. CONCLUSIONS AND RELEVANCE Depression is confirmed as a pro-inflammatory state. Some of the inflammatory markers elevated in depression, including CRP and IL-12, show reduced variability in patients with depression, therefore supporting greater homogeneity in terms of an inflammatory phenotype in depression. Some inflammatory marker elevations in depression do not appear due to an inflamed sub-group, but rather to a right shift of the immune marker distribution.
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Affiliation(s)
- Emanuele F. Osimo
- MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, London, UK,Department of Psychiatry, University of Cambridge, Cambridge, UK,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Toby Pillinger
- MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, London, UK,Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | | | - Golam M. Khandaker
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Carmine M. Pariante
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,National Institute for Health Research, Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK,The Maurice Wohl Clinical Neuroscience Institute, Cutcombe Road, London SE5 9RT, UK
| | - Oliver D. Howes
- MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, London, UK,Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,Corresponding author at: MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, London, UK.
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Perrin AJ, Horowitz MA, Roelofs J, Zunszain PA, Pariante CM. Glucocorticoid Resistance: Is It a Requisite for Increased Cytokine Production in Depression? A Systematic Review and Meta-Analysis. Front Psychiatry 2019; 10:423. [PMID: 31316402 PMCID: PMC6609575 DOI: 10.3389/fpsyt.2019.00423] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/28/2019] [Indexed: 12/29/2022] Open
Abstract
Background: Glucocorticoid resistance-reduced function of the glucocorticoid receptor (GR)-is seen in many depressed patients. It is argued that this resistance to glucocorticoids leads to failure of normal feedback regulation on the immune system. High levels of pro-inflammatory cytokines result. Purpose: We sought to identify evidence supporting or refuting a link between glucocorticoid resistance and immune dysregulation in depression and to summarize retrieved evidence in aggregate form. Methods: We systematically reviewed and meta-analyzed studies that examined cytokine levels in depressed patients compared with controls and that also reported a measure of glucocorticoid resistance. These measures included plasma cortisol, the dexamethasone suppression test (DST), GR expression levels, and the results of in vitro assays of GR function. We conducted four separate meta-analyses to test for moderating effects of glucocorticoid resistance on cytokine production in depression. Results: After sub-grouping 32 studies by the ratio of cortisol levels in patients compared with controls, we observed a trend for increasing glucocorticoid resistance (i.e., the most hypercortisolemic patients) to be associated with increased production of interleukin (IL)-6 [d = 0.94; 95% CI (0.29, 1.59)] and tumour necrosis factor (TNF)-α [d = 0.46; 95% CI (0.12, 0.79)]. We stratified nine studies that reported DST results by relative glucocorticoid resistance between patients and controls, identifying a trend for higher glucocorticoid resistance in patients, compared with controls, to be associated with higher cytokine production in patients (170 patients and 187 controls). This was particularly evident when studies were sub-grouped by source of cytokine-plasma (d = 1.04; 95% CI, 0.57-1.50) versus in vitro (d = 0.24; 95% CI, -0.20 to 0.67). Stratifying the four studies (147 patients and 118 controls) that used in vitro assays of GR function or GR expression to quantify glucocorticoid resistance revealed variable contributions to cytokine production in patients compared with controls (overall effect size: d = 1.35; 95% CI 0.53-2.18). Combining our analyses of studies that reported DST results with those that used in vitro assays of GR function or GR expression to quantify glucocorticoid resistance (302 patients and 277 controls), we noted that although depressed patients produced more cytokines than controls (d = 1.02; 95% CI, 0.55-1.49), there was no evident positive correlation between glucocorticoid resistance and inflammation. Conclusions: Our work provides some support for a model conceptualizing glucocorticoid resistance as a requisite for increased inflammation in depression. The limited number of studies identified highlights the need for purpose-designed investigations that directly examine the relationship between glucocorticoid resistance and cytokine production in depression.
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Affiliation(s)
- Andrew J. Perrin
- Stress, Psychiatry and Immunology Laboratory, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Clinician Investigator Program and Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Mark A. Horowitz
- Stress, Psychiatry and Immunology Laboratory, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Jacob Roelofs
- Stress, Psychiatry and Immunology Laboratory, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Patricia A. Zunszain
- Stress, Psychiatry and Immunology Laboratory, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Carmine M. Pariante
- Stress, Psychiatry and Immunology Laboratory, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
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Abstract
This cross-sectional study aimed at measuring the correlation and association between serum levels of cortisol, inflammatory cytokines, and depression and to measure the detection accuracy of serum levels of cortisol in serum samples. In total, 89 male participants were recruited into this study from June 15, 2017, to September 31, 2017. The Hamilton Depression Rating Scale, Beck Anxiety Inventory, and Pittsburgh Sleep Quality Index were used to investigate the mental health status of the participants. Serum concentrations of cortisol and inflammatory cytokines were determined. The serum cortisol concentration, anxiety level, and sleep quality were included in the final logistic regression model. Serum cortisol was able to accurately distinguish between patients with depression and those without depression. There was a significant positive correlation between serum cortisol levels and Hamilton Depression Rating Scale scores.
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Inflammatory Profiles in Depressed Adolescents Treated with Fluoxetine: An 8-Week Follow-up Open Study. Mediators Inflamm 2018; 2018:4074051. [PMID: 30662368 PMCID: PMC6312587 DOI: 10.1155/2018/4074051] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 07/30/2018] [Accepted: 08/28/2018] [Indexed: 12/17/2022] Open
Abstract
Changes in cytokine levels in major depression and during treatment have been reported in adults. However, few studies have examined cytokine levels in an adolescent sample despite this being a common age of onset. Methods. We measured proinflammatory (IL-2, IFN-γ, IL-1β, TNF-α, IL-6, IL-12, and IL-15) and anti-inflammatory (IL-4, IL-5, IL-13, IL-1Ra, and IL-10) cytokine serum levels in 22 adolescents with major depression and 18 healthy volunteers. Cytokines were measured by multiplex bead-based immunoassays at baseline, and 4 and 8 weeks after commencement of fluoxetine administration in the clinical group. Results. Compared to healthy volunteers, adolescents with major depression at baseline showed significant increases in all pro- and anti-inflammatory cytokines, except IL-1Ra and IL-10. Significant changes were observed in fluoxetine treatment compared to baseline: proinflammatory cytokines IFN-γ, IL-1β, TNF-α, IL-6, IL-12, and IL-15 were decreased only at week 4 whereas IL-2 was increased only at week 8; anti-inflammatory cytokines IL-4 and IL-5 were increased at week 8 while IL-1Ra was reduced only at week 4. There were no significant correlations between cytokine levels and symptomatic improvement in HDRS. Discussion. The results suggest a significant interplay between cytokine levels, the depressive state, and the stage of treatment with an SSRI. To the best of our knowledge, this is the first report in depressed adolescents with elevated IL-12, IL-13, and IL-15 levels. Further studies are necessary to clarify the role and mechanisms of altered cytokine levels in the pathogenesis and physiopathology of major depressive disorder.
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He D, Sai X, Wang N, Li X, Wang L, Xu Y. Camellia euphlebia exerts its antidepressant-like effect via modulation of the hypothalamic-pituitary-adrenal axis and brain monoaminergic systems. Metab Brain Dis 2018; 33:301-312. [PMID: 29247282 DOI: 10.1007/s11011-017-0167-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 12/11/2017] [Indexed: 01/20/2023]
Abstract
Camellia euphlebia (family, Theaceae) is a Chinese folk medicine, known for its multiple pharmacological properties. The present study aimed to provide further insights into the therapeutic basis of C. euphlebia using several animal behavioral tests and physiological indexes. Tail suspension test, forced swimming test, open-field test, chronic unpredictable mild stress (CUMS), reversal of reserpine-induced hypothermia and palpebral ptosis, and 5-hydroxytryptophane-induced head-twitch response were used to evaluate the antidepressant effect of aqueous extract of Camellia euphlebia (AEC) on mice. The possible underlying mechanism was explored by investigating the changes associated with several parameters of animal behavior, as well as the changes in monoamine neurotransmitter and stress hormone levels in these animals during the tests. Mice administered AEC at 100 and 200 mg/kg/day doses for 7 days showed significantly reduced immobility duration in forced swimming test and tail suspension test, whilst exhibiting no apparent changes in locomotor activity. Additionally, administration of AEC also effectively antagonized reserpine-induced palpebral ptosis and hypothermia and enhanced 5-hydroxytryptophane-induced head-twitch response. AEC significantly elevated the levels of serotonin, noradrenaline and dopamine in the blood and brain compared to non-treated mice. After 28 days of administration, the maximum AEC dose (100 mg/kg/day) significantly reversed CUMS-induced inhibition of weight gain and sucrose intake, while decreasing the levels of plasma adrenocorticotropic hormone and serum corticosterone. The antidepressant effect of AEC appeared to involve the alteration of hypothalamic-pituitary-adrenal axis and monoaminergic systems.
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Affiliation(s)
- Dongye He
- School of Life Science and Biotechnology, Dalian University of Technology, Dalian, 116024, China
- Ministry of Education Center for Food Safety of Animal Origin, Dalian University of Technology, Dalian, 116620, China
| | - Xuan Sai
- School of Life Science and Biotechnology, Dalian University of Technology, Dalian, 116024, China
- Ministry of Education Center for Food Safety of Animal Origin, Dalian University of Technology, Dalian, 116620, China
| | - Ning Wang
- School of Life Science and Biotechnology, Dalian University of Technology, Dalian, 116024, China
- Ministry of Education Center for Food Safety of Animal Origin, Dalian University of Technology, Dalian, 116620, China
| | - Xiaoyu Li
- School of Life Science and Biotechnology, Dalian University of Technology, Dalian, 116024, China
- Ministry of Education Center for Food Safety of Animal Origin, Dalian University of Technology, Dalian, 116620, China
| | - Lili Wang
- School of Life Science and Biotechnology, Dalian University of Technology, Dalian, 116024, China
- Ministry of Education Center for Food Safety of Animal Origin, Dalian University of Technology, Dalian, 116620, China
| | - Yongping Xu
- School of Life Science and Biotechnology, Dalian University of Technology, Dalian, 116024, China.
- Ministry of Education Center for Food Safety of Animal Origin, Dalian University of Technology, Dalian, 116620, China.
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13
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Zhuang F, Zhou X, Gao X, Lou D, Bi X, Qin S, Sun C, Ye P, Wang Y, Ma T, Li M, Gu S. Cytokines and glucocorticoid receptors are associated with the antidepressant-like effect of alarin. Peptides 2016; 76:115-29. [PMID: 26779986 DOI: 10.1016/j.peptides.2016.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 12/06/2015] [Accepted: 01/08/2016] [Indexed: 01/06/2023]
Abstract
Little is known about the physiological or pharmacological properties of alarin, a new neuropeptide belonging to the galanin family. We previously showed that alarin has an antidepressant-like effect and is associated with a decrease in the hyperactivity of hypothalamic-pituitary-adrenal (HPA) axis that is observed in patients with depression using unpredictable chronic mild stress (UCMS) mouse model of depression. However, the mechanisms underlying these effects have not been uncovered. Inflammatory cytokines are reportedly associated with depression. Animal studies and cytokine immune therapy in humans suggest that pro-inflammatory cytokines induce depressive symptomatology and potently activate the HPA axis, whereas anti-inflammatory cytokines may decrease activation. Thus, we first determined the levels of inflammatory cytokines in the blood and brain to evaluate whether the antidepressant-like effect of alarin in UCMS-treated mice is related to its regulation of these inflammatory cytokines. Pro-inflammatory cytokines disrupt the function and/or expression of glucocorticoid receptors (GRs), which mediate the negative feedback of glucocorticoids on the HPA axis to keep it from being overactivated. We next explored the expression level of GRs in the brains of mice subjected to UCMS and to the administration of alarin. We found that intracerebroventricular administration of alarin significantly ameliorated depression-like behaviors in the UCMS-treated mice. Alarin restored the UCMS-induced an increase in the levels of the pro-inflammatory cytokines interleukin (IL)-6 and tumor necrosis factor α and a decrease in the anti-inflammatory cytokine IL-10 level in the blood, prefrontal cortex, hippocampus and hypothalamus. Alarin also reversed the UCMS-induced down-regulation of GR expression in these brain regions. Thus, the antidepressant-like effects of alarin may be mediated by restoring altered pro-inflammatory and anti-inflammatory cytokine levels and GR expression to decrease HPA axis hyperactivity. Our findings provide additional knowledge to interpret the pathophysiology of depression.
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Affiliation(s)
- Fuzhi Zhuang
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Department of Pharmacology, Xuzhou Medical College, Xuzhou 221004, China
| | - Xue Zhou
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Department of Pharmacology, Xuzhou Medical College, Xuzhou 221004, China
| | - Xin Gao
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Department of Pharmacology, Xuzhou Medical College, Xuzhou 221004, China
| | - Dan Lou
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Department of Pharmacology, Xuzhou Medical College, Xuzhou 221004, China
| | - Xuesheng Bi
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Department of Pharmacology, Xuzhou Medical College, Xuzhou 221004, China
| | - Shoujun Qin
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Department of Pharmacology, Xuzhou Medical College, Xuzhou 221004, China
| | - Chuxiao Sun
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Department of Pharmacology, Xuzhou Medical College, Xuzhou 221004, China
| | - Peng Ye
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Department of Pharmacology, Xuzhou Medical College, Xuzhou 221004, China
| | - Yun Wang
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Department of Pharmacology, Xuzhou Medical College, Xuzhou 221004, China
| | - Tengfei Ma
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Department of Pharmacology, Xuzhou Medical College, Xuzhou 221004, China
| | - Mei Li
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Department of Pharmacology, Xuzhou Medical College, Xuzhou 221004, China
| | - Shuling Gu
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Department of Pharmacology, Xuzhou Medical College, Xuzhou 221004, China.
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Xing H, Zhang K, Zhang R, Shi H, Bi K, Chen X. Antidepressant-like effect of the water extract of the fixed combination of Gardenia jasminoides, Citrus aurantium and Magnolia officinalis in a rat model of chronic unpredictable mild stress. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2015; 22:1178-1185. [PMID: 26598917 DOI: 10.1016/j.phymed.2015.09.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 09/11/2015] [Accepted: 09/15/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Water extract of the fixed combination of Gardenia jasminoides Ellis fruit, Citrus aurantium L. fruit and Magnolia officinalis Rehd. et Wils. bark, traditional name - Zhi-Zi-Hou-Po (ZZHPD) is used for treatment of depressive-like symptoms in traditional Chinese medicine for centuries. HYPOTHESIS/PURPOSE The present study aimed to explore antidepressant-like effects and potential mechanisms of ZZHPD in a rat model of chronic unpredictable mild stress (CUMS). STUDY DESIGN Antidepressant-like effects of ZZHPD were investigated through behavioral tests, and potential mechanism was assessed by neuroendocrine system, neurotrophin and hippocampal neurogenesis. METHODS Antidepressant-like effects of ZZHPD (3.66, 7.32 and 14.64 g/kg/day) were estimated through coat state test, sucrose preference test, forced swimming test and open-field test. Effects of ZZHPD on hypothalamic-pituitary-adrenal (HPA) axis were evaluated by hormones measurement and dexamethasone suppression test. In addition, the expression of brain-derived neurotrophic factor (BDNF) in hippocampus was measured, as well as hippocampal neurogenesis was investigated by doublecortin (DCX) and 5-bromo-2-deoxyuridine/neuronal nuclei (BrdU/NeuN). RESULTS The results demonstrated that ZZHPD significantly reversed the depressive-like behaviors, normalized the levels of adrenocorticotropic hormone (ACTH) and corticosterone (CORT), restored the negative feedback loop of HPA axis and improved the levels of BDNF, DCX and BrdU/NeuN compared with those in CUMS-induced rats. CONCLUSION The above results revealed that ZZHPD exerted antidepressant-like effects possibly by normalizing HPA axis function, increasing expression of BDNF in hippocampus and promoting hippocampal neurogenesis.
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Affiliation(s)
- Hang Xing
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China
| | - Kuo Zhang
- Department of Pharmacology, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China
| | - Ruowen Zhang
- Stem Cell Institute, Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Shelby Interdisciplinary Biomedical Building, Room 777, 1825 University Blvd, Birmingham, AL 35294-0024, USA
| | - Huiyan Shi
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China
| | - Kaishun Bi
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China
| | - Xiaohui Chen
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China.
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15
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Byrne ML, O'Brien-Simpson NM, Mitchell SA, Allen NB. Adolescent-Onset Depression: Are Obesity and Inflammation Developmental Mechanisms or Outcomes? Child Psychiatry Hum Dev 2015; 46:839-50. [PMID: 25666100 DOI: 10.1007/s10578-014-0524-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Depression often has its first onset during adolescence and is associated with obesity. Furthermore, inflammatory processes have been implicated in both depression and obesity, although research amongst adolescents is limited. This review explores associations between depression and obesity, depression and inflammation, and obesity and inflammation from a developmental perspective. The temporal relations between these factors are examined to explore whether obesity and elevated inflammation act as either risk factors for, or outcomes of, adolescent-onset depression. Sex differences in these processes are also summarized. We propose a model whereby increases in sex hormones during puberty increase risk for depression for females, which can lead to obesity, which in turn increases levels of inflammation. Importantly, this model suggests that inflammation and obesity are outcomes of adolescent depression, rather than initial contributing causes. Further research on biological and psychosocial effects of sex hormones is needed, as is longitudinal research with children and adolescents.
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Affiliation(s)
- Michelle L Byrne
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia.
| | - Neil M O'Brien-Simpson
- Melbourne Dental School, Oral Health CRC, The University of Melbourne, 720 Swanston Street, Carlton, VIC, 3010, Australia
| | - Sarah A Mitchell
- Faculty of Medicine, Nursing and Health Sciences, School of Psychology and Psychiatry, Monash University, Melbourne, VIC, 3800, Australia
| | - Nicholas B Allen
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia.,Department of Psychology, University of Oregon, Eugene, OR, 97403-1227, USA
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Shelton RC, Falola M, Li L, Zajecka J, Fava M, Papakostas GI. The pro-inflammatory profile of depressed patients is (partly) related to obesity. J Psychiatr Res 2015; 70:91-7. [PMID: 26424427 PMCID: PMC4734093 DOI: 10.1016/j.jpsychires.2015.09.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 08/24/2015] [Accepted: 09/01/2015] [Indexed: 01/01/2023]
Abstract
Many people with major depressive disorder (MDD) show evidence of systemic inflammation, including elevations in inflammatory factors, but the cause is unclear. The purpose of this analysis was to determine if obesity might contribute to the pro-inflammatory state in MDD patients. Blood was obtained from 135 MDD patients and 50 controls. Serum was extracted and assayed for interleukin (IL) -1β, IL-2, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17, interferon-γ (IFNγ), tumor necrosis factor α (TNFα), C-reactive protein (CRP), leptin, and adiponectin using single- or multi-plex human immunoassay kits. The primary analysis contrasted IL-6, TNFα, and CRP between MDD and control groups with body mass index (BMI) as a covariate. The other analytes were compared in an exploratory fashion. IL-6 (but not TNFα or CRP) showed significant differences between MDD and controls even after covarying for BMI. Obese controls and obese MDD groups were significantly higher in IL-6 than both lean groups, but the two obese groups did not differ from each other. In the exploratory analyses, the IL-2 level showed robust and significant differences between MDD and controls even after covarying for BMI. Both lean and obese MDD were higher than lean and obese controls. Adiponectin levels were also lower in the MDD sample than controls. Prior findings of higher IL-6, and CRP in MDD patients may be explained, at least in part, based on obesity. High IL-2, however, was associated with depression and not obesity. The results have significant implications for the understanding of pathophysiology and, potentially treatment of MDD.
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Affiliation(s)
| | - Michael Falola
- Department of Psychiatry, The University of Alabama, Birmingham, AL
| | - Li Li
- Department of Psychiatry, The University of Alabama, Birmingham, AL
| | - John Zajecka
- Department of Psychiatry, Rush Medical Center, 1700 W. Van Buren Street, 5th Floor, Chicago, IL, 60612
| | - Maurizio Fava
- Department of Psychiatry and the Clinical Trials Network and Institute (CTNI), Massachusetts General Hospital, 15 Parkman St, Boston, MA 02114
| | - George I. Papakostas
- Department of Psychiatry and the Clinical Trials Network and Institute (CTNI), Massachusetts General Hospital, 15 Parkman St, Boston, MA 02114
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Ye L, Hu Z, Wang H, Zhu H, Dong Z, Jiang W, Zhao H, Li N, Mi W, Wang W, Hu X. Tris-(2,3-Dibromopropyl) Isocyanurate, a New Emerging Pollutant, Impairs Cognition and Provokes Depression-Like Behaviors in Adult Rats. PLoS One 2015; 10:e0140281. [PMID: 26458255 PMCID: PMC4601767 DOI: 10.1371/journal.pone.0140281] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 09/23/2015] [Indexed: 01/11/2023] Open
Abstract
Tris-(2,3-dibromopropyl) isocyanurate (TDBP-TAZTO), an emerging brominated flame retardant, possesses the characteristics of candidate persistent organic pollutants and has displayed toxicity to fish and rodents. TDBP-TAZTO can pass through the blood brain barrier and accumulate in brain. However, the neurotoxicity of TDBP-TAZTO has not yet studied in rodents. We hypothesize that TDBP-TAZTO could induce the neurotoxicity in rat hippocampal neurons. The male adult rats were exposed to TDBP-TAZTO of 5 and 50 mg/kg by gavage, daily for 6 months. TDBP-TAZTO resulted in cognitive impairment and depression-like behaviors, which may be related with TDBP-TAZTO-induced hypothalamic-pituitary-adrenal axis hyperactivation, upregulation of inflammatory and oxidative stress markers, overexpression of pro-apoptotic proteins, downexpression of neurogenesis-related proteins in hippocampus, and hippocampal neurons damage in DG, CA1 and CA3 areas. Our findings suggested that TDBP-TAZTO induces significant hippocampal neurotoxicity, which provokes cognitive impairment and depression-like behaviors in adult rats. Therefore, this research will contribute to evaluate the neurotoxic effects of TDBP-TAZTO in human.
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Affiliation(s)
- Liang Ye
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, PR China
- Institute of Toxicology, Binzhou Medical University, Yantai, Shandong, PR China
| | - Zhengping Hu
- Medicine & Pharmacy Research Center, Binzhou Medical University, Yantai, Shandong, PR China
| | - Hui Wang
- School of Pharmacy, Yantai University, Yantai, Shandong, PR China
| | - Haibo Zhu
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, PR China
- Institute of Toxicology, Binzhou Medical University, Yantai, Shandong, PR China
| | - Zhaoju Dong
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, PR China
| | - Wanglin Jiang
- School of Pharmacy, Binzhou Medical University, Yantai, Shandong, PR China
| | - Huijuan Zhao
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, PR China
| | - Ning Li
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, PR China
| | - Wei Mi
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, PR China
| | - Wenyan Wang
- School of Pharmacy, Yantai University, Yantai, Shandong, PR China
| | - Xihou Hu
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, PR China
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Zhu G, Yin Y, Xiao CL, Mao RJ, Shi BH, Jie Y, Wang ZW. Serum DHEAS levels are associated with the development of depression. Psychiatry Res 2015. [PMID: 26205628 DOI: 10.1016/j.psychres.2015.05.093] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of study was to evaluate the association between serum DHEAS levels and depression with a case-control study together with a meta-analysis. Radioimmunoassay (RIA) was performed to measure the serum DHEAS levels of all participants before and after treatment. Depression Patients were divided into mild depression and severe depression based on Hamilton depression scale (HAMD24) and received 5-hydroxytryptamine (5-HT) and citalopram (20mg/d) for 8 weeks. Case-control studies related to our study theme were enrolled for meta-analysis and Comprehensive Meta-analysis 2.0 (CMA 2.0) was used for statistical analysis. After treatment, DHEAS levels in depression patients were significantly increased, while before and after treatment, DHEAS levels were all lower in depression patients than in controls (all P<0.001); further analysis on age revealed that DHEAS levels were decreased with the rising of age. Meta-analysis results suggested that serum DHEAS levels (ng/mL) were significantly higher in healthy controls compared to depression patients (SMD=0.777, 95%CI=0.156-1.399, P=0.014). In conclusion, our study suggests that serum DHEAS levels are associated with the development of depression and it decreased with the rising of age.
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Affiliation(s)
- Guang Zhu
- Department of Psychiatry, Shanghai Hongkou District Mental Health Center, Shanghai 200083, PR China.
| | - You Yin
- Department of Neurology, Shanghai Changzheng Hospital, Secondary Military Medical University, Shanghai 200003, PR China
| | - Chun-Lan Xiao
- Department of Psychiatry, Shanghai Hongkou District Mental Health Center, Shanghai 200083, PR China
| | - Rong-Jie Mao
- Department of Psychiatry, Shanghai Hongkou District Mental Health Center, Shanghai 200083, PR China
| | - Bo-Hai Shi
- Department of Psychiatry, Shanghai Hongkou District Mental Health Center, Shanghai 200083, PR China
| | - Yong Jie
- Department of Psychiatry, Shanghai Hongkou District Mental Health Center, Shanghai 200083, PR China
| | - Zuo-Wei Wang
- Department of Psychiatry, Shanghai Hongkou District Mental Health Center, Shanghai 200083, PR China
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19
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Hu Q, Zhang SY, Liu F, Zhang YL, Zhu DM, Zang YY. Clinical significance of decreased protein expression of dehydroepiandrosterone sulfate in the development of depression: a meta-analysis. J Affect Disord 2015; 174:416-23. [PMID: 25553402 DOI: 10.1016/j.jad.2014.11.051] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 11/24/2014] [Accepted: 11/25/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND Previous evidence has shown that adrenal androgens, dehydroepiandrosterone (DHEA) and its sulfate derivative (DHEAS) have significant functions related to the control of mood, affect, and anxiety. Changes in their expression levels are reportedly related to several psychiatric disorders. The objective of this meta-analysis was to explore the role of DHEAS protein expression in patients with depression. METHOD Web of Science, Cochrane Library, CISCOM, CINAHL, Google Scholar, China BioMedicine (CBM) and China National Knowledge Infrastructure (CNKI) were electronically searched. Only those studies that analyzing DHEAS expression in depression patients were considered eligible for inclusion. Standardized mean differences (SMDs) were pooled with a 95% confidence interval (CI) in accordance with the random-effects model. RESULTS Ten clinical case-control studies, consisting of 4496 subjects (493 patients with depression and 4003 healthy controls) were incorporated for analysis. Results revealed a lower DHEAS protein expression level in patients with depression than in normal controls (SMD=0.17, 95% CI: 0.06-0.27, P=0.002). Ethnicity-stratified analysis indicated that lower levels of DHEAS expression in depression patients were not observed in Caucasians or Asians (both P>0.05). CONCLUSION Elevated DHEAS protein expression may be correlated with the biological pathophysiology of depression, indicating that checking DHEAS levels and administration of DHEAS could contribute to the effective treatment of depression.
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Affiliation(s)
- Qiang Hu
- Department of Psychology, Qiqihar Mental Health Center, Qiqihar 161000, PR China.
| | - Sheng-Yu Zhang
- Institute of Forensic Science, Ministry of Justice, Shanghai Key Lab of Forensic Medicine, Shanghai 200063, PR China.
| | - Fei Liu
- Department of Psychiatry, Tongji Hospital, Tongji University, Shanghai 200000, PR China
| | - Yan-Li Zhang
- Department of Psychology, Qiqihar Mental Health Center, Qiqihar 161000, PR China
| | - Dian-Ming Zhu
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai 200000, PR China
| | - Yin-Yin Zang
- Center for the Treatment and Study of Anxiety, University of Pennsylva, Philadelphia 19104, United States
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20
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Duggal NA, Upton J, Phillips AC, Hampson P, Lord JM. NK cell immunesenescence is increased by psychological but not physical stress in older adults associated with raised cortisol and reduced perforin expression. AGE (DORDRECHT, NETHERLANDS) 2015; 37:9748. [PMID: 25663421 PMCID: PMC4320126 DOI: 10.1007/s11357-015-9748-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 01/22/2015] [Indexed: 06/04/2023]
Abstract
NK cell cytotoxicity (NKCC) reduces with age and this has been associated previously with increased mortality. The immune response is also modulated by stress, and here, we assessed the effect of the physical stress of hip fracture and the psychological stress of depression on NKCC in an aged immune system. NKCC was assessed in 101 hip fracture patients (81 female) 6 weeks and 6 months after injury and in 50 healthy age-matched controls (28 female). Thirty-eight patients were depressed at 6 weeks post-injury, and NKCC was reduced in patients who developed depression compared with non-depressed hip fracture patients (p = 0.004) or controls (p < 0.02). NKCC remained lower in the depressed patients compared to those without depression 6 months post-fracture (p = 0.017). We found reduced expression of perforin in NK cells of depressed hip fracture patients compared with controls at 6 weeks (p = 0.001) post-fracture. Serum cortisol levels were also elevated in patients with depression compared to non-depressed patients at 6 weeks (p = 0.01) and 6 months (p = 0.05). NK cells treated with dexamethasone showed a concentration-dependent reduction in NKCC and perforin expression. We propose that depression is the major factor affecting NK cell immunity after hip fracture.
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Affiliation(s)
- Niharika Arora Duggal
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, School of Immunity and Infection, University of Birmingham, Birmingham, B15 2TT UK
| | - Jane Upton
- School of Sport and Exercise Sciences, University of Birmingham, Birmingham, B15 2TT UK
| | - Anna C. Phillips
- School of Sport and Exercise Sciences, University of Birmingham, Birmingham, B15 2TT UK
| | - Peter Hampson
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, School of Immunity and Infection, University of Birmingham, Birmingham, B15 2TT UK
| | - Janet M. Lord
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, School of Immunity and Infection, University of Birmingham, Birmingham, B15 2TT UK
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21
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Jiang M, Qin P, Yang X. Comorbidity between depression and asthma via immune-inflammatory pathways: a meta-analysis. J Affect Disord 2014; 166:22-9. [PMID: 25012406 DOI: 10.1016/j.jad.2014.04.027] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 04/07/2014] [Accepted: 04/12/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Depression is often present in patients with asthma and vice versa. In this review, we aimed to summarize reports on the comorbidity of depression and asthma, and to seek evidence that the biological mechanisms of allergy may have an important role linking asthma and depression. METHOD To explore the relationship and pathway underpinning this comorbidity, we reviewed medical articles and undertook a meta-analysis of epidemiological studies on (i) incidence of asthma in patients with depression; (ii) morbidity of depression in patients with asthma; (iii) concentration of cytokines in depressed subjects. RESULTS High level of comorbidity of asthma and depression was consistently demonstrated in 10 studies of patients with asthma and four studies of patients with depression. In search of biological connection of the two illnesses, thirty-eight studies were included for Meta-analyses examining differences in allergy related cytokines between patients with depression and non-depressive subjects. In people with depression, concentration of monocytes related cytokines such as IL-1 (1.56ng/mL, 95% CI: 0.00-3.12, p=0.05) was significantly higher than that in non-depressive control subjects. At the same time, some other inflammatory factors including IL-4 (5.77pg/mL, 95% CI: 2.34-9.21, p=0.00010), IL-6 (1.44ng/mL, 95% CI: 1.05-1.82, p<0.00001) and TNF-α(3.01ng/mL, 95% CI: 1.76-4.26, p<0.00001) were extremely significantly higher in depressed people compared with the controls. There was no significant differences of the T cell related cytokine levels, IFN-γ (-0.16ng/mL, 95% CI: -0.85-7.73, p=0.97), accompanied with IL-10 (0.67ng/mL, 95% CI: -0.84-2.18, p=0.38) between depressive and non-depressive groups. CONCLUSIONS The varying levels of certain cytokines play an important role in arousing and remitting asthma and depression. That suggests inflammatory response could be a common pathway adjusting both depression and asthma.
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Affiliation(s)
- Mingdi Jiang
- Section of Environmental Biomedicine, Hubei Key Laboratory of Genetic Regulation and Integrative Biology, College of Life Sciences, Central China Normal University, Wuhan 430079, China
| | - Ping Qin
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Xu Yang
- Section of Environmental Biomedicine, Hubei Key Laboratory of Genetic Regulation and Integrative Biology, College of Life Sciences, Central China Normal University, Wuhan 430079, China.
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Ogłodek E, Szota A, Just M, Moś D, Araszkiewicz A. The role of the neuroendocrine and immune systems in the pathogenesis of depression. Pharmacol Rep 2014; 66:776-81. [PMID: 25149980 DOI: 10.1016/j.pharep.2014.04.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 04/14/2014] [Accepted: 04/16/2014] [Indexed: 12/21/2022]
Abstract
Development of depression is associated with the body's response to prolonged stress, which adversely affects the functioning of the nervous, endocrine and immune systems. Prolonged stress can lead to the development of a so-called allostatic load and reduction of concentration of brain-derived neurotrophic factor. These changes result in impairment of neurogenesis and synaptic remodeling process. This article illustrates the involvement of key mediators of allostasis such as the neuroendocrine and immune systems, in the pathogenesis of depression. The literature concerning the contribution of the neuroendocrine and immune systems to depression incidence was reviewed. Development of depression is associated with disturbance of the body's allostasis and inflammatory activation of the immune system. It leads to a chronic increase in the concentration of cortisol and proinflammatory cytokines, which results in an allostatic load. This load leads to neurodegeneration, eventually causing irreversible cognitive impairment and permanent disability. Determination of the concentration of chemokines and their receptors is an important indicator of activation of the immune and neuroendocrine systems. The activity of these systems reflects the severity of the disease and provides important information for effective antidepressant treatment.
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Affiliation(s)
- Ewa Ogłodek
- Department of Psychiatry, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland.
| | - Anna Szota
- Department of Psychiatry, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
| | - Marek Just
- Piekary Medical Centre, Department of General Surgery, Municipal Hospital in Piekary Śląskie, Poland
| | - Danuta Moś
- Health Care Centre Euro-Med Bytom, Poland
| | - Aleksander Araszkiewicz
- Department of Psychiatry, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
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Jankowska EA, Drohomirecka A, Ponikowska B, Witkowska A, Lopuszanska M, Szklarska A, Borodulin-Nadzieja L, Banasiak W, Poole-Wilson PA, Ponikowski P. Deficiencies in circulating testosterone and dehydroepiandrosterone sulphate, and depression in men with systolic chronic heart failure. Eur J Heart Fail 2014; 12:966-73. [DOI: 10.1093/eurjhf/hfq108] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ewa A. Jankowska
- Department of Heart Diseases, Faculty of Health Sciences; Wroclaw Medical University Military Hospital; ul. Weigla 5 50-981 Wroclaw Poland
- Centre for Heart Disease; Military Hospital; Wroclaw Poland
- Institute of Anthropology, Polish Academy of Sciences; Wroclaw Poland
| | | | - Beata Ponikowska
- Department of Physiology; Wroclaw Medical University; Wroclaw Poland
| | | | | | - Alicja Szklarska
- Institute of Anthropology, Polish Academy of Sciences; Wroclaw Poland
| | | | | | - Philip A. Poole-Wilson
- Cardiac Medicine, Royal Brompton Hospital; National Heart and Lung Institute, Imperial College London; London UK
| | - Piotr Ponikowski
- Department of Heart Diseases, Faculty of Health Sciences; Wroclaw Medical University Military Hospital; ul. Weigla 5 50-981 Wroclaw Poland
- Centre for Heart Disease; Military Hospital; Wroclaw Poland
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Byrne ML, O'Brien-Simpson NM, Reynolds EC, Walsh KA, Laughton K, Waloszek JM, Woods MJ, Trinder J, Allen NB. Acute phase protein and cytokine levels in serum and saliva: a comparison of detectable levels and correlations in a depressed and healthy adolescent sample. Brain Behav Immun 2013; 34:164-75. [PMID: 23999491 DOI: 10.1016/j.bbi.2013.08.010] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 08/15/2013] [Accepted: 08/23/2013] [Indexed: 12/23/2022] Open
Abstract
Recent research has examined associations between inflammation and mental health, and has increasingly focused on utilising younger samples to characterise the temporal relationship between inflammatory responses and the emergence of other symptoms. These studies have typically used blood to measure inflammation, although rates of detection for many inflammatory markers appear to be low. Saliva is a safe and low-cost alternative, and adult research has shown that levels of some salivary markers correlate well with those in serum. However, no research has examined this association in young people. This study examined 16 inflammatory markers in serum and saliva in 17 depressed adolescents and 18 healthy controls, aged 13-18 years. In general, detection rates were higher in saliva compared to in serum. When non-detectable levels were excluded, serum levels of C-reactive protein (CRP) correlated with salivary CRP (r=0.424, p=0.015), and this correlation appeared to only exist for those individuals with high levels of serum CRP (r=0.599, p=0.014). However, when non-detectable levels were included as zero, salivary levels of CRP, interleukin (IL)-2, IL-12p70, and interferon (IFN)-γ correlated with their serum counterparts. No significant clinical group differences in any acute phase proteins or cytokines were present. This study suggests that saliva can be used to measure inflammation in studies with adolescent participants, especially CRP, as it appears to correlate with systemic inflammation for those individuals who are expected to have high levels of inflammation. Implications for future directions in research on salivary inflammatory markers are discussed.
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Affiliation(s)
- Michelle L Byrne
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia
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Serum dehydroepiandrosterone (DHEA) and DHEA-sulfate (S) levels in medicated patients with major depressive disorder compared with controls. J Affect Disord 2013; 146:205-12. [PMID: 23102506 DOI: 10.1016/j.jad.2012.09.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 09/04/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND There is accumulating evidence regarding gender differences in clinical symptoms or response to antidepressants in patients with depression. However, less attention has been given to sex differences in the underlying biological mechanisms of depression. The adrenal androgens, dehydroepiandrosterone (DHEA) and its sulfate derivative (DHEA-S), play a critical role in controlling affect, mood, and anxiety. Changes in serum adrenal androgen levels have been reported in conditions pertaining to stress as well as in psychiatric disorders. The objective of the present study was to investigate differences in serum levels of adrenal androgens in male and female patients with major depressive disorder (MDD). METHODS Participants included 90 inpatients with MDD at the psychiatric ward of Juntendo University Koshigaya Hospital who were receiving antidepressants. Serum levels of DHEA and DHEA-S were assessed at the time of admission. Matched controls (based on sex and age) included 128 healthy individuals. First, data from male and female MDD patients and controls were compared. Second, correlations between serum hormone levels and scores on the Hamilton Rating Scale for Depression (HAM-D) of patients with MDD were assessed by gender. In addition, effects of various factors on adrenal androgens were analyzed using multiple regression analysis. RESULTS Serum DHEA levels were significantly increased in both male and female MDD patients compared with controls. Serum levels of DHEA-S in male patients were significantly decreased compared with male controls, whereas no significant differences were seen in female patients and controls. No significant correlations among adrenal androgens were observed in male patients with MDD, whereas significant positive correlations were found in both male and female controls. No significant correlations were seen between adrenal androgens and HAM-D scores in male or female patients. Multiple regression analysis showed that both hormones were affected by the age at onset of depression. LIMITATIONS All subjects in the present study were on antidepressant medications. CONCLUSIONS Elevated levels of serum DHEA may be associated with the biological pathophysiology of depression, as DHEA administration has been found to be effective for the treatment of depression. Findings of differential changes in DHEA-S levels in men compared with women may suggest distinct characteristics of these hormones between men and women with depression. However, DHEA/DHEA-S may be a poor indicator for evaluating severity of depression.
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Ye L, Hu Z, Du G, Zhang J, Dong Q, Fu F, Tian J. Antidepressant-like effects of the extract from Cimicifuga foetida L. JOURNAL OF ETHNOPHARMACOLOGY 2012; 144:683-691. [PMID: 23069943 DOI: 10.1016/j.jep.2012.10.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 10/01/2012] [Accepted: 10/07/2012] [Indexed: 06/01/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cimicifuga foetida L., a traditional Chinese medicine, has been developed for the treatment of perimenopausal symptoms including depression in China (Brand name: XIMINGTING(®), XMT). The primary active constituents are believed to be the triterpene glycosides. Nevertheless, there are no studies about the antidepressant-like effects of XMT in rodents. AIMS OF THE STUDY The present study aimed to evaluate antidepressant-like effects of XMT. MATERIALS AND METHODS Antidepressant-like activity of XMT was studied using forced swimming test (FST) and tail suspension test (TST) in female mice, as well as chronic mild stress (CMS) procedure in female rats. In addition, 5-hydroxytryptophan (5-HTP)-induced head-twitch test and yohimbine toxicity potentiation test in female mice were conducted to propose the possible serotonergic or noradrenergic mechanisms in the antidepressant-like effects of XMT. In mice, XMT was administrated acutely and for 7 consecutive days (20, 40 and 80 mg/kg/day, p.o.); and in rats for 28 consecutive days (10, 20 and 40 mg/kg/day, p.o.). RESULTS XMT significantly reduced immobility duration in FST and TST without affecting locomotor activity, increased swimming and climbing durations in FST, and enhanced 5-HTP-induced head-twitch response while did not affect yohimbine-induced lethality in female mice. XMT also normalized the inhibition of sucrose intake and decreased the levels of plasma adrenocorticotropic hormone and serum corticosterone and adrenal gland weight in CMS-treated female rats. CONCLUSIONS These data indicate XMT processes antidepressant-like properties in rodents, which could be related to its serotonergic and noradrenergic activation and normalization of the hypothalamic-pituitary-adrenal axis.
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Affiliation(s)
- Liang Ye
- School of Pharmacy, Yantai University & State Key Laboratory of Long-acting and Targeting Drug Delivery Technologies, Yantai, Shandong 264003, PR China
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Liu Y, Ho RCM, Mak A. Interleukin (IL)-6, tumour necrosis factor alpha (TNF-α) and soluble interleukin-2 receptors (sIL-2R) are elevated in patients with major depressive disorder: a meta-analysis and meta-regression. J Affect Disord 2012; 139:230-9. [PMID: 21872339 DOI: 10.1016/j.jad.2011.08.003] [Citation(s) in RCA: 672] [Impact Index Per Article: 56.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 08/01/2011] [Accepted: 08/01/2011] [Indexed: 12/14/2022]
Abstract
BACKGROUND Many studies have explored the association between soluble interleukin-2 receptor (sIL-2R), cytokines and major depressive disorder (MDD). However, the results of these studies were not consistent. The aim of our study is to compare the levels of sIL-2R and cytokines in the blood between MDD patients and controls by a meta-analysis and to identify moderators accounting for potential heterogeneity in the levels of sIL-2R and cytokines in MDD patients versus controls by meta-regression analyses. METHODS A comprehensive literature search was performed to identify studies comparing the levels of sIL-2R and cytokines between MDD patients and controls. We pooled the effect sizes for standardized mean differences (SMD) of the levels of sIL-2R and cytokines. We also performed meta-regression and sensitivity analyses to investigate the roles of age, gender, sample type, ethnic origin and selected studies' quality in explaining potential heterogeneity and differences in results respectively. RESULTS Twenty-nine studies were selected for this analysis. The levels of sIL-2R, TNF-α and IL-6 in MDD patients were significantly higher than those of healthy controls (SMD=0.555, p<0.001, SMD=0.567, p=0.010; SMD=0.680, p<0.001). Mean age of all subjects was a significant moderator to explain the high heterogeneity of IL-6. Sensitivity analysis found that European but not non-European subjects have higher levels difference of sIL-2R, TNF-α and IL-1β between MDD patients and controls. LIMITATION The severity of MDD was not considered. CONCLUSION The blood levels of sIL-2R, TNF-α and IL-6 were significantly higher in MDD patients than controls. Age, samples source and ethnic origins may play a potential role in heterogeneity.
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Affiliation(s)
- Yang Liu
- Department of Psychological Medicine, University Medicine Cluster, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Frih H, Djenidi R, Ali Rachedi B, Frih N, Tahraoui A, Bairi AM. Le kétoconazole antagonise les effets immuno-gonadotropes au test de la nage forcée chez le rat mâle Wistar. Can J Physiol Pharmacol 2010; 88:733-44. [DOI: 10.1139/y10-048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
On a souvent rapporté que la dépression s’installe suite à des perturbations des activités de l’axe corticotrope et du système immunitaire. L’objectif de cette étude était d’explorer les effets du kétoconazole, un dérivé d’imidazole, inhibiteur de la stéroïdogénèse gonadique et surrénalienne, sur les variations du nombre de leucocytes totaux et des pourcentages de sous-populations leucocytaires, au cours de la nage forcée chez le rat (test de Porsolt), un test consiste à tester l’efficacité des antidépresseurs. Des cathéters ont été implantés, sous anesthésie générale, dans la carotide droite, et des prises de sang (0,2 mL) ont été réalisées à des intervalles de 15 min au cours de l’expérimentation, alors que les animaux pouvaient se comporter librement. Les degrés d’anxiété et d’activité locomotrice des rats ont été mesurés au labyrinthe en croix surélevée et au test des champs ouverts. La nage forcée a provoqué des fluctuations du système immunitaire et de la testostéronémie, lesquelles qui ont été inhibées suite au traitement des animaux au kétoconazole. Cet effet a été obtenu également sur le plan comportemental (labyrinthe en croix surélevée, nage forcée) dans le sens d’une amélioration (effets anxiolytique et antidépresseur). Ces résultats suggèrent que les réponses comportementales et physiologiques sont inter-reliées d’une manière multifactorielle et que la corticostérone joue un rôle clé dans la pathogénie des maladies psychiatriques.
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Affiliation(s)
- Hacène Frih
- Laboratoire de neuroendocrinologie appliquée, Département de Biologie, Faculté des Sciences, Université Badji Mokhtar Annaba, B.P. 12, El Hadjar, Algérie
- Laboratoire d’écophysiologie animale, Département de Biologie, Faculté des Sciences, Université Badji Mokhtar Annaba, B.P. 12, El Hadjar, Algérie
- Département de psychologie, Université Ben Aknoun Alger, Algérie
| | - Réda Djenidi
- Laboratoire de neuroendocrinologie appliquée, Département de Biologie, Faculté des Sciences, Université Badji Mokhtar Annaba, B.P. 12, El Hadjar, Algérie
- Laboratoire d’écophysiologie animale, Département de Biologie, Faculté des Sciences, Université Badji Mokhtar Annaba, B.P. 12, El Hadjar, Algérie
- Département de psychologie, Université Ben Aknoun Alger, Algérie
| | - Bachir Ali Rachedi
- Laboratoire de neuroendocrinologie appliquée, Département de Biologie, Faculté des Sciences, Université Badji Mokhtar Annaba, B.P. 12, El Hadjar, Algérie
- Laboratoire d’écophysiologie animale, Département de Biologie, Faculté des Sciences, Université Badji Mokhtar Annaba, B.P. 12, El Hadjar, Algérie
- Département de psychologie, Université Ben Aknoun Alger, Algérie
| | - Nabila Frih
- Laboratoire de neuroendocrinologie appliquée, Département de Biologie, Faculté des Sciences, Université Badji Mokhtar Annaba, B.P. 12, El Hadjar, Algérie
- Laboratoire d’écophysiologie animale, Département de Biologie, Faculté des Sciences, Université Badji Mokhtar Annaba, B.P. 12, El Hadjar, Algérie
- Département de psychologie, Université Ben Aknoun Alger, Algérie
| | - Abdelkrim Tahraoui
- Laboratoire de neuroendocrinologie appliquée, Département de Biologie, Faculté des Sciences, Université Badji Mokhtar Annaba, B.P. 12, El Hadjar, Algérie
- Laboratoire d’écophysiologie animale, Département de Biologie, Faculté des Sciences, Université Badji Mokhtar Annaba, B.P. 12, El Hadjar, Algérie
- Département de psychologie, Université Ben Aknoun Alger, Algérie
| | - Abdel Majid Bairi
- Laboratoire de neuroendocrinologie appliquée, Département de Biologie, Faculté des Sciences, Université Badji Mokhtar Annaba, B.P. 12, El Hadjar, Algérie
- Laboratoire d’écophysiologie animale, Département de Biologie, Faculté des Sciences, Université Badji Mokhtar Annaba, B.P. 12, El Hadjar, Algérie
- Département de psychologie, Université Ben Aknoun Alger, Algérie
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Howk C, Bennett M. Immune function and health outcomes in women with depression. Biopsychosoc Med 2010; 4:3. [PMID: 20438639 PMCID: PMC2878291 DOI: 10.1186/1751-0759-4-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Accepted: 05/03/2010] [Indexed: 11/25/2022] Open
Abstract
This research reports immune function and health outcomes in women with depression, as compared with a non-depressed control group. Using Psychoneuroimmunolgy theory and a descriptive comparison design, scores on the Beck Depression Inventory (BDI) were used to divide 40 non-hospitalized Caucasian women between the ages of 18 and 65 years into either the control or depression comparison group. Women with depression were found to report significantly more incidences of illness over the previous two months and they were found to have significantly more indicators of illness at the time of the exam as compared to the controls. However, contrary to what has been documented in some earlier studies of depression, women with depression were not found to have significantly different immune function measures as compared to the control group. There was also no significant correlation between scores on the BDI and natural killer cell cytotoxicity in this study. While these findings support a connection between depression and both increased self-report of illness and increased signs and symptoms of minor illness or inflammation on physical exam, this study was not able to document that these effects were related to decreased immune function, as measured by natural killer cell activity or white blood cell counts.
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Affiliation(s)
- Cherie Howk
- Western Kentucky University, School of Nursing, 101 Lynn Rich Drive, Alvaton KY, 42122 USA.
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30
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A meta-analysis of cytokines in major depression. Biol Psychiatry 2010; 67:446-57. [PMID: 20015486 DOI: 10.1016/j.biopsych.2009.09.033] [Citation(s) in RCA: 3199] [Impact Index Per Article: 228.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2009] [Revised: 08/31/2009] [Accepted: 09/26/2009] [Indexed: 02/08/2023]
Abstract
BACKGROUND Major depression occurs in 4.4% to 20% of the general population. Studies suggest that major depression is accompanied by immune dysregulation and activation of the inflammatory response system (IRS). Our objective was to quantitatively summarize the data on concentrations of specific cytokines in patients diagnosed with a major depressive episode and controls. METHODS We performed a meta-analysis of studies measuring cytokine concentration in patients with major depression, with a database search of the English literature (to August 2009) and a manual search of references. RESULTS Twenty-four studies involving unstimulated measurements of cytokines in patients meeting DSM criteria for major depression were included in the meta-analysis; 13 for tumor necrosis factor (TNF)-alpha, 9 for interleukin (IL)-1beta, 16 for IL-6, 5 for IL-4, 5 for IL-2, 4 for IL-8, 6 for IL-10, and 4 for interferon (IFN)-gamma. There were significantly higher concentrations of TNF-alpha (p < .00001), weighted mean difference (WMD) (95% confidence interval) 3.97 pg/mL (2.24 to 5.71), in depressed subjects compared with control subjects (438 depressed/350 nondepressed). Also, IL-6 concentrations were significantly higher (p < .00001) in depressed subjects compared with control subjects (492 depressed/400 nondepressed) with an overall WMD of 1.78 pg/mL (1.23 to 2.33). There were no significant differences among depressed and nondepressed subjects for the other cytokines studied. CONCLUSIONS This meta-analysis reports significantly higher concentrations of the proinflammatory cytokines TNF-alpha and IL-6 in depressed subjects compared with control subjects. While both positive and negative results have been reported in individual studies, this meta-analytic result strengthens evidence that depression is accompanied by activation of the IRS.
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Hernandez ME, Martinez-Fong D, Perez-Tapia M, Estrada-Garcia I, Estrada-Parra S, Pavón L. Evaluation of the effect of selective serotonin-reuptake inhibitors on lymphocyte subsets in patients with a major depressive disorder. Eur Neuropsychopharmacol 2010; 20:88-95. [PMID: 20005081 DOI: 10.1016/j.euroneuro.2009.11.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Revised: 11/02/2009] [Accepted: 11/12/2009] [Indexed: 11/26/2022]
Abstract
To date, only the effect of a short-term antidepressant treatment (<12 weeks) on neuroendocrinoimmune alterations in patients with a major depressive disorder has been evaluated. Our objective was to determine the effect of a 52-week long treatment with selective serotonin-reuptake inhibitors on lymphocyte subsets. The participants were thirty-one patients and twenty-two healthy volunteers. The final number of patients (10) resulted from selection and course, as detailed in the enrollment scheme. Methods used to psychiatrically analyze the participants included the Mini-International Neuropsychiatric Interview, Hamilton Depression Scale and Beck Depression Inventory. The peripheral lymphocyte subsets were measured in peripheral blood using flow cytometry. Before treatment, increased counts of natural killer (NK) cells in patients were statistically significant when compared with those of healthy volunteers (312+/-29 versus 158+/-30; cells/mL), but no differences in the populations of T and B cells were found. The patients showed remission of depressive episodes after 20 weeks of treatment along with an increase in NK cell and B cell populations, which remained increased until the end of the study. At the 52nd week of treatment, patients showed an increase in the counts of NK cells (396+/-101 cells/mL) and B cells (268+/-64 cells/mL) compared to healthy volunteers (NK, 159+/-30 cells/mL; B cells, 179+/-37 cells/mL). We conclude that long-term treatment with selective serotonin-reuptake inhibitors not only causes remission of depressive symptoms, but also affects lymphocyte subset populations. The physiopathological consequence of these changes remains to be determined.
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Zhou D, Jin H, Lin HB, Yang XM, Cheng YF, Deng FJ, Xu JP. Antidepressant effect of the extracts from Fructus Akebiae. Pharmacol Biochem Behav 2010; 94:488-95. [DOI: 10.1016/j.pbb.2009.11.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Revised: 10/30/2009] [Accepted: 11/12/2009] [Indexed: 11/29/2022]
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Abstract
Psychiatric disorders especially depression are associated with a variety of changes in immunity parameters. In this work, an attempt was carried out to make estimation about the correlation between immunity and depression through the measuring of IgG, IgA, and IgM and complements (C3 and C4) levels in the serum of patients and comparing them with the corresponding levels of healthy control group. The results showed a significant increase in serum level of C3, C4, cortisol, IgG and no significant differences were noticed in the level of IgA and IgM in the depressed patients group as compared with control group. A slight positive correlation was observed between cortisol versus IgG in depressed patients that is not found in normal subjects. Thus in depression, human body defenses psychologically and sometimes this defense transformed into immunological resistance that is expressed as different measurable changes in immunological parameters.
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34
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Chronic mild stress impairs cognition in mice: from brain homeostasis to behavior. Life Sci 2008; 82:934-42. [PMID: 18402983 DOI: 10.1016/j.lfs.2008.02.010] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2007] [Revised: 01/27/2008] [Accepted: 02/19/2008] [Indexed: 11/20/2022]
Abstract
Exposure to chronic stress in rodents and psychosocial stress in humans has been shown to alter cognitive functions and has been linked to the pathophysiology of mood disorders. The purpose of the present study was to investigate effects and possible mechanisms of a chronic mild stress (CMS) procedure on cognitive behaviors in Swiss albino mice using the object recognition test (ORT) and object location test (OLT). Results showed that CMS exposure impaired cognitive performance and produced amnesia of acquired information in both ORT and OLT. Furthermore, the cognitive impairment was coexistent with increased plasma levels of interleukin-1beta (IL-1beta), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha), as well as with enhanced plasma levels of corticosterone (CORT), corticotrophin-releasing hormone (CRH) and adrenocorticotrophic hormone (ACTH). In addition, severe neuronal cell damage was found, as bromodeoxyuridine (BrdU) positive cells and the expression of brain derived neurotrophic factor (BDNF) in dentate gyrus (DG) of hippocampus were decreased after 5 weeks CMS procedure. Taken together, these findings indicated that CMS exposure-induced impairment of cognitive behaviors might be attributed to the stress-related alterations in brain homeostasis that were reflected in changes in the neuroimmune and neuroendocrine systems as well as in neurogenesis.
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Andrade S, Silveira SL, Gomez R, Barros HMT, Ribeiro MFM. Gender differences of acute and chronic administration of dehydroepiandrosterone in rats submitted to the forced swimming test. Prog Neuropsychopharmacol Biol Psychiatry 2007; 31:613-21. [PMID: 17223242 DOI: 10.1016/j.pnpbp.2006.12.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2006] [Revised: 11/21/2006] [Accepted: 12/06/2006] [Indexed: 11/19/2022]
Abstract
Previous pre-clinical and clinical studies investigating the antidepressant potential of DHEA revealed conflicting results. In this study, the effects of exogenous DHEA on performance in the forced swimming test (FST) were examined in male and female Wistar rats in different phases of the estrous cycle. Furthermore, the effects of treatment and of the FST, on corticosterone and DHEA serum levels were investigated. Acute administration of DHEA (2 mg/kg) significantly increased freezing only in proestrus female rats. Similarly, the chronic administration of DHEA (2 mg/kg) increased freezing duration and decreased climbing behavior but only in females in diestrus II compared to those given vehicle. These results demonstrate that chronically administered DHEA induces a depressant-like effect, and this effect is sex dependent. There was no direct correlation between corticosterone levels or the corticosterone/DHEA ratio and the behaviors studied. After the FST, serum DHEA and corticosterone levels were increased, with females showing higher DHEA levels than males. Nevertheless, corticosterone levels were unaltered with chronic procedure; an effect that was independent of sex and treatment. These findings are relevant for research examining alternative treatment for depression and may elucidate the gender differences involved in stress-related diseases.
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Affiliation(s)
- S Andrade
- Department of Physiology, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Tsao CW, Lin YS, Chen CC, Bai CH, Wu SR. Cytokines and serotonin transporter in patients with major depression. Prog Neuropsychopharmacol Biol Psychiatry 2006; 30:899-905. [PMID: 16616982 DOI: 10.1016/j.pnpbp.2006.01.029] [Citation(s) in RCA: 154] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/30/2006] [Indexed: 11/24/2022]
Abstract
Altered cytokine secretion as a mechanism in the etiology of depression is still obscure. The serotonin transporter (5-HTT) may play an important role in the termination of serotonergic neurotransmission by serotonin (5-HT) uptaking into presynaptic neurons and representing as an initial action site for selective 5-HTT reuptake inhibitors (SSRI). In our study, we evaluated whether cytokines and 5-HTT acted as biological markers for depression. Blood samples were collected from 42 participants. The differences in cytokine and 5-HTT mRNA expressions of leukocytes were assessed between the patients with major depression (n=20) and the healthy controls (n=22), along with the measurements prior and after treatment with a SSRI, fluoxetine, for 3 months in the follow-up patient group (n=8). The results revealed that the mRNA expressions of IL-1beta, IL-6, IFNgamma, TNFalpha, and 5-HTT were higher in the depressed patients than those of the healthy controls. The higher level of mRNA expressions of IFNgamma and 5-HTT diminished after fluoxetine treatment. Furthermore, we found a positive correlation between 5-HTT and cytokines mRNA expressions in total participants, which suggested that pro-inflammatory cytokines and 5-HTT might play critical roles in the pathogenesis of major depression and that their levels were affected by chronic treatment with 5-HTT inhibitors.
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Affiliation(s)
- Chiung-Wen Tsao
- Department of Nursing, Chung Hwa College of Medical Technology, Tainan County, Taiwan
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Pavón L, Sandoval-López G, Eugenia Hernández M, Loría F, Estrada I, Pérez M, Moreno J, Avila U, Leff P, Antón B, Heinze G. Th2 cytokine response in Major Depressive Disorder patients before treatment. J Neuroimmunol 2006; 172:156-65. [PMID: 16457895 DOI: 10.1016/j.jneuroim.2005.08.014] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2005] [Accepted: 08/22/2005] [Indexed: 11/18/2022]
Abstract
In Major Depressive Disorder (MDD), the neuroendocrine and immune systems interactions are impaired. We investigated the pro/anti-inflammatory Th1/Th2 cytokine balance in MDD patients and in non-depressed control group. The MDD subjects showed higher levels of cortisol and TNF-alpha, increased CD3+CD8+ and NK percentages, diminished B cell counts and no significant variations in CD3+CD4+ lymphocyte. Moreover, higher levels of IL-4 and IL-13 (Th2) and significantly lower measurements of IL-2 and IFN-gamma (Th1) cytokines were also observed in the MDD group. Overall, we propose that all these changes could be related to the elevated cortisol levels seen in the MDD patients. Further studies are necessary to explore these findings and its implication in future therapeutic approach of MDD patients.
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Affiliation(s)
- Lenin Pavón
- Department of Psychoimmunology, National Institute of Psychiatry Ramón de la Fuente, México
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Xia X, Pan Y, Zhang WY, Cheng G, Kong LD. Ethanolic Extracts from Curcuma longa Attenuates Behavioral, Immune, and Neuroendocrine Alterations in a Rat Chronic Mild Stress Model. Biol Pharm Bull 2006; 29:938-44. [PMID: 16651723 DOI: 10.1248/bpb.29.938] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The ethanolic extracts from the rhizome of Curcuma longa L. (turmeric), possesses a wide variety of biological activities related to the treatment and prevention of affective disorders. To study their antidepressant effects, the impacts of chronic mild stress (CMS) and of the subsequent administration of ethanolic extracts of C. longa were investigated. Male Sprague-Dawley rats subjected to the CMS procedure demonstrated increased serum interleukin-6 and tumor necrosis factor-alpha levels, as well as a reduction of natural killer cell activity in splenocytes. In addition, CMS-treated rats exhibited elevated corticotropin-releasing factor in serum and medulla oblongata and cortisol levels in serum, with no significant change in serum adrenocorticotropin hormone levels. The preferential behavior of reduction in sucrose intake was also observed. These findings indicate that the alterations in immune and hypothalamic-pituitary-adrenal (HPA) axis systems could participate in the behavioral response to the CMS procedure in animals. Administration of ethanolic extracts of C. longa largely reversed the above effects. These results demonstrate the antidepressant-like activity of ethanolic extracts of C. longa in the rat CMS model of depression, at least in part by improving the abnormalities in immune and the HPA axis functions.
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Affiliation(s)
- Xing Xia
- State Key Laboratory of Pharmaceutical Biotechnology, Immunobiological Laboratory, Nanjing University, PR China
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Gladkevich A, Kauffman HF, Korf J. Lymphocytes as a neural probe: potential for studying psychiatric disorders. Prog Neuropsychopharmacol Biol Psychiatry 2004; 28:559-76. [PMID: 15093964 DOI: 10.1016/j.pnpbp.2004.01.009] [Citation(s) in RCA: 283] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/30/2004] [Indexed: 01/13/2023]
Abstract
There is an increasing body evidence pointing to a close integration between the central nervous system (CNS) and immunological functions with lymphocytes playing therein a central role. The authors provide arguments to consider blood lymphocytes as a convenient probe of--an albeit--limited number of cellular functions, including gene expression. The use of brain biopsies of living patients is unrealistic for biochemical investigation, therefore lymphocytes may be a convenient and accessible alternative. Numerous studies showed similarities between receptor expression and mechanisms of transduction processes of cells in the nervous system (e.g. neurons and glia) and lymphocytes. In several neuropsychiatric disorders, alteration of metabolism and cellular functions in the CNS, as well as disturbances in the main neurotransmitter and hormonal systems are concomitant with altered function and metabolism of blood lymphocytes. We summarize relevant investigations on depression, stress, Alzheimer's disease (AD) and schizophrenia. New techniques such as cDNA microarray gene expression and proteomics may give clues to define molecular abnormalities in psychiatric disorders and could eventually reveal information for diagnostic and treatment purposes. Taken together, these considerations suggest that lymphocyte could reflect the metabolism of brain cells, and may be exploited as a neural and possible genetic probe in studies of psychiatric disorders.
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Affiliation(s)
- Anatoliy Gladkevich
- Department of Biological Psychiatry, University Hospital Groningen, Groningen, The Netherlands.
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