Depressive disorders are associated with increased peripheral blood cell deformability: A cross-sectional case-control study (Mood-Morph)

Abstract

Background. Pathophysiological landmarks of depressive disorders are chronic low-grade inflammation and elevated glucocorticoid output. Both can potentially interfere with cell membrane bending and cell function, suggesting altered cell morpho-rheological properties like cell deformability and other cell mechanical features in depressive disorders. Method. We performed a cross-sectional case-control study using image-based morpho-rheological characterization of unmanipulated blood samples facilitating real-time deformability cytometry (RT-DC). Sixty-nine pre-screened individuals at high-risk for depressive disorders and 70 matched healthy controls were included and clinically evaluated by Composite International Diagnostic Interview. Facilitating deep learning on blood cell images, major blood cell types were classified and morpho-rheological parameters such as cell size and cell deformability of every individual cell was quantified. Results. We found peripheral blood cells to be more deformable in patients with depressive disorders compared to controls, while cell size was not affected. Lifetime persistent depressive disorder was associated with an increased cell deformability in monocytes and neutrophils, while in current persistent depressive disorder erythrocytes deformed more. Lymphocytes were more deformable in current major depressive disorder, while for lifetime major depressive disorder no differences could be identified. Conclusions. This is the first study analyzing morpho-rheological properties of entire blood cells and highlighting depressive disorders and in particular persistent depressive disorders to be associated with increased blood cell deformability. While all major blood cells tend to be more deformable, lymphocytes, monocytes, and neutrophils are mostly affected. This indicates that immune cell mechanical changes occur in depressive disorders, which might be predictive for persistent immune response.

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“…Accordingly, the production and release of interleukin-1β, interleukin-6, and tumor necrosis factor-α were enhanced, and these biomarkers evolved into chronic inflammation and produced systemic inflammation (33). Furthermore, the increase of immune cell counts can elevate glucocorticoid levels, which can remodel the actin cytoskeleton of blood cells, impact cell morpho-rheological properties, and alter peripheral blood cell function (10).…”

“…Zhang and colleagues have written an excellent review on physical activity and depression by demonstrating an inverse association between physical activity and depressive symptoms in older adults (7). Similar to increased physical activity, reduced time spent on sitting was also reported to be beneficial for mental health (10), and sedentary behavior is increasingly regarded as a distinct cardiovascular risk factor (11). Physical activity and sedentary behavior have become a focus of much research, especially using the National Health and Nutrition Examination Survey (NHANES) database (12)(13)(14)(15).…”