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Halaris A, Hain D, Law R, Brown L, Lewis D, Filip M. Single nucleotide polymorphisms in C-reactive protein (CRP) predict response to adjunctive celecoxib treatment of resistant bipolar depression. Brain Behav Immun Health 2023; 30:100625. [PMID: 37181328 PMCID: PMC10172701 DOI: 10.1016/j.bbih.2023.100625] [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: 10/01/2022] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 05/16/2023] Open
Abstract
Background Affective illness has been associated with a proinflammatory state, and it is generally accepted that the immune system plays a key role in the pathophysiology of mood disorders. Since inflammatory biomarkers are elevated in bipolar disorder, anti-inflammatory combination therapies may enhance response and reverse treatment resistance. Purpose In the present study we investigated the possible impact of single nucleotide polymorphisms (SNPs) within the CRP gene on CRP blood levels, treatment response and level-of-stress perception in our cohort of treatment-resistant bipolar-depressed patients receiving escitalopram and celecoxib, or escitalopram and placebo, as previously reported (Halaris et al., 2020). Methods Study design, clinical findings, and CRP blood levels have been reported previously (Halaris et al., 2020; Edberg et al., 2018). In this follow-up study we extracted DNA from blood cells collected at baseline. Genome-wide genotyping was performed for all subjects using the Infinium Multi-Ethnic Global-8 v1.0 Kit. Based on reports in the literature indicating possible associations with psychiatric conditions, ten previously reported CRP gene polymorphisms were evaluated in a preliminary analysis. We focused on rs3093059 and rs3093077 were in complete LD. Carriers were defined as those possessing at least one C allele for rs3093059, or at least one G allele for rs3093077. Additionally, we determined blood levels of the medications administered. Results Non-carriers of rs3093059 and rs3093077 had significantly lower baseline CRP blood levels than carriers (p = 0.03). Increased rates of HAM-D17 response (p = 0.21) and remission (p = 0.13) and lower PSS-14 scores (p = 0.13) were observed in non-carriers among subjects receiving celecoxib but they did not reach statistical significance. When examining all subjects, nominally significant associations between carrier-status and remission (p = 0.04) and PSS-14 scores (p = 0.04) were observed after correcting for treatment arm. Non-carriers receiving celecoxib had the highest rates of response and remission, and the lowest stress scores. Conclusions Carriers of the CRP SNPs may have higher baseline CRP levels, although non-carriers appear to benefit more from celecoxib co-therapy. Determination of the carrier status in conjunction with pretreatment blood CRP level measurement may contribute to personalized psychiatric practice, but replication of the present findings is needed.
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Affiliation(s)
- Angelos Halaris
- Loyola University School of Medicine and Loyola University Medical Center, 2160 South First Ave., Maywood, IL, 60153, USA
- Corresponding author.
| | - Daniel Hain
- Myriad Neuroscience, 6960 Cintas Blvd, Mason, OH, 45040, USA
| | - Rebecca Law
- Myriad Neuroscience, 6960 Cintas Blvd, Mason, OH, 45040, USA
| | - Lisa Brown
- Myriad Neuroscience, 6960 Cintas Blvd, Mason, OH, 45040, USA
| | - David Lewis
- Myriad Neuroscience, 6960 Cintas Blvd, Mason, OH, 45040, USA
| | - Maria Filip
- Department of Adult Psychiatry Medical University of Lodz, Aleksandrowska 159, 91-229, Lodz, Poland
- The Polish National Agency for Academic Exchange, Polna 40, 00-635, Warsaw, Poland
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C-Reactive Protein as a Biomarker for Major Depressive Disorder? Int J Mol Sci 2022; 23:ijms23031616. [PMID: 35163538 PMCID: PMC8836046 DOI: 10.3390/ijms23031616] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 11/16/2022] Open
Abstract
The etiopathogenesis of depression is not entirely understood. Several studies have investigated the role of inflammation in major depressive disorder. The present work aims to review the literature on the association between C-Reactive Protein (CRP) and depression. A systematic review was performed for the topics of ‘CRP’ and ‘depression’ using the PubMed database from inception to December 2021. Fifty-six studies were identified and included in the review. Evidence suggested the presence of dysregulation in the inflammation system in individuals with depression. In most studies, higher blood CRP levels were associated with greater symptom severity, a specific pattern of depressive symptoms, and a worse response to treatment. Moreover, about one-third of depressed patients showed a low-grade inflammatory state, suggesting the presence of a different major depressive disorder (MDD) subgroup with a distinct etiopathogenesis, clinical course, treatment response, and prognosis, which could benefit from monitoring of CRP levels and might potentially respond to anti-inflammatory treatments. This work provides robust evidence about the potential role of CRP and its blood levels in depressive disorders. These findings can be relevant to developing new therapeutic strategies and better understanding if CRP may be considered a valuable biomarker for depression.
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Stanikova D, Zsido RG, Luck T, Pabst A, Enzenbach C, Bae YJ, Thiery J, Ceglarek U, Engel C, Wirkner K, Stanik J, Kratzsch J, Villringer A, Riedel-Heller SG, Sacher J. Testosterone imbalance may link depression and increased body weight in premenopausal women. Transl Psychiatry 2019; 9:160. [PMID: 31175272 PMCID: PMC6555814 DOI: 10.1038/s41398-019-0487-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 03/23/2019] [Accepted: 04/02/2019] [Indexed: 01/16/2023] Open
Abstract
Accumulating evidence supports a link between depression and being overweight in women. Given previously reported sex differences in fat accumulation and depression prevalence, as well as the likely role of sex hormones in both overweight and mood disorders, we hypothesised that the depression-overweight association may be mediated by sex hormones. To this end, we investigated the association of being overweight with depression, and then considered the role of sex hormones in relation to being overweight and depression in a large population-based cohort. We included a total of 3124 women, 970 premenopausal and 2154 postmenopausal from the LIFE-Adult cohort study in our analyses. We evaluated associations between being overweight (BMI >25 kg/m2), sex hormone levels, and depressive symptomatology according to Centre for Epidemiologic Studies Depression (CES-D) scores, and explored mediation of depression in a mediation model. Being overweight was significantly associated with depressive symptoms in premenopausal but not postmenopausal women. Both premenopausal and postmenopausal overweight women had higher free testosterone levels compared with normal weight women. Premenopausal women with depressive symptomatology had higher free testosterone levels compared to women without. We found a significant mediation effect of depressive symptomatology in overweight premenopausal women through free testosterone level. These findings highlight the association between being overweight and depressed, and suggest that high free testosterone levels may play a significant role in depression of overweight premenopausal women. Based on this, pharmacological approaches targeting androgen levels in overweight depressed females, in particular when standard anti-depressive treatments fail, could be of specific clinical relevance.
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Affiliation(s)
- Daniela Stanikova
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany. .,DIABGENE Laboratory, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia. .,Department of Pediatrics, Medical Faculty at the Comenius University, Bratislava, Slovakia.
| | - Rachel G. Zsido
- 0000 0001 0041 5028grid.419524.fDepartment of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany ,0000 0001 0041 5028grid.419524.fEmotion & NeuroimaGinG (EGG) Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Tobias Luck
- Department of Economic and Social Sciences & Institute of Social Medicine, Rehabilitation Sciences and Healthcare Research (ISRV), University of Applied Sciences Nordhausen, Nordhausen, Germany ,0000 0001 2230 9752grid.9647.cLIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Alexander Pabst
- 0000 0001 2230 9752grid.9647.cInstitute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Cornelia Enzenbach
- 0000 0001 2230 9752grid.9647.cLIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany ,0000 0001 2230 9752grid.9647.cInstitute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Yoon Ju Bae
- 0000 0001 2230 9752grid.9647.cInstitute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
| | - Joachim Thiery
- 0000 0001 2230 9752grid.9647.cLIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany ,0000 0001 2230 9752grid.9647.cInstitute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
| | - Uta Ceglarek
- 0000 0001 2230 9752grid.9647.cLIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany ,0000 0001 2230 9752grid.9647.cInstitute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
| | - Christoph Engel
- 0000 0001 2230 9752grid.9647.cLIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany ,0000 0001 2230 9752grid.9647.cInstitute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Kerstin Wirkner
- 0000 0001 2230 9752grid.9647.cLIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Juraj Stanik
- 0000 0001 2180 9405grid.419303.cDIABGENE Laboratory, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia ,0000000109409708grid.7634.6Department of Pediatrics, Medical Faculty at the Comenius University, Bratislava, Slovakia ,0000 0001 2230 9752grid.9647.cCenter for Pediatric Research Leipzig, University Hospital for Children & Adolescents, University of Leipzig, Leipzig, Germany
| | - Juergen Kratzsch
- 0000 0001 2230 9752grid.9647.cInstitute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
| | - Arno Villringer
- 0000 0001 0041 5028grid.419524.fDepartment of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany ,0000 0001 0041 5028grid.419524.fEmotion & NeuroimaGinG (EGG) Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany ,0000 0001 2230 9752grid.9647.cClinic of Cognitive Neurology, University of Leipzig, Leipzig, Germany
| | - Steffi G. Riedel-Heller
- 0000 0001 2230 9752grid.9647.cInstitute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Julia Sacher
- 0000 0001 0041 5028grid.419524.fDepartment of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany ,0000 0001 0041 5028grid.419524.fEmotion & NeuroimaGinG (EGG) Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany ,0000 0001 2230 9752grid.9647.cClinic of Cognitive Neurology, University of Leipzig, Leipzig, Germany
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