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Neuron. 2018 Sep 5;99(5):914-924.e3. doi: 10.1016/j.neuron.2018.08.001. Epub 2018 Aug 23.

Defective Inflammatory Pathways in Never-Treated Depressed Patients Are Associated with Poor Treatment Response.

Author information

1
Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
2
Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA.
3
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Psychology, Emory University, Atlanta, GA, USA.
4
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
5
Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL, USA.
6
Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Physiology and Biophysics, University of Miami Miller School of Medicine, Miami, FL, USA.
7
Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA. Electronic address: cnemeroff@med.miami.edu.

Abstract

Inflammation has been involved in the pathophysiology and treatment response of major depressive disorder (MDD). Plasma cytokine profiles of 171 treatment-naive MDD patients (none of the MDD patients received an adequate trial of antidepressants or evidence-based psychotherapy) and 64 healthy controls (HCs) were obtained. MDD patients exhibited elevated concentrations of 18 anti- and proinflammatory markers and decreased concentrations of 6 cytokines. Increased inflammasome protein expression was observed in MDD patients, indicative of an activated inflammatory response. The plasma of MDD patients was immunosuppressive on healthy donor peripheral blood mononuclear cells, inducing reduced activation of monocytes/dendritic cells and B cells and reduced T cell memory. Comparison between 33 non-responders and 71 responders at baseline and 12 weeks revealed that after treatment, anti-inflammatory cytokine levels increase in both groups, whereas 5 proinflammatory cytokine levels were stabilized in responders, but continued to increase in non-responders. MDD patients exhibit remodeling of their inflammatory landscape.

KEYWORDS:

PBMC; T cell memory; cytokines; defective anti-inflammatory pathway; inflammasome; major depressive disorder; treatment naive

PMID:
30146307
PMCID:
PMC6151182
[Available on 2019-09-05]
DOI:
10.1016/j.neuron.2018.08.001

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