Objective-Depression and stress promote proinflammatory cytokine production. Dietary intakes of omega-3 (n-3) and omega-6 (n-6) polyunsaturated fatty acids (PUFAs) also influence inflammation; high n-6:n-3 ratios enhance proinflammatory cytokine production, while n-3 has anti-inflammatory properties. This study addressed how interactions between PUFA levels and depressive symptoms were related to proinflammatory cytokine synthesis.Methods-Blood samples from 43 older adults (mean age = 66.67, SD=10.09) provided data on PUFAs and TNF-α, IL-6, and sIL-6r. Depressive symptoms were assessed by the CES-D.Results-Depressive symptoms and n-6:n-3 ratios worked together to enhance proinflammatory cytokines beyond the contribution provided by either variable alone, with substantial variance explained by their interaction: 13% for IL-6 and 31% for TNF-α, whereas full models accounted for 18% and 40%, respectively. Although predicted cytokine levels were fairly consistent across n-6:n-3 ratios with low depressive symptoms, higher n-6:n-3 ratios were associated with progressively elevated TNF-α and IL-6 levels as depressive symptoms increased. Higher levels of sIL-6r were associated with higher n-6:n-3 ratios. Six individuals who met criteria for major depressive disorder had higher n-6:n-3 ratios and TNF-α, IL-6, and sIL-6r levels than those who did not meet criteria; excluding these 6 individuals reduced the variance explained by the depressive symptoms and n-6:n-3 ratio interaction.Conclusions-Diets with high n-6:n-3 PUFA ratios may enhance risk for both depression and inflammatory diseases. Keywords depression; proinflammatory cytokines; omega-3; psychoneuroimmunology Depression is the most common psychiatric illness, and both major depression and subthreshold depressive symptoms carry substantial health risks (1,2). A number of wellcontrolled prospective studies have linked depressive symptoms with coronary heart disease (CHD), the leading cause of death in the United States (3); moreover, the nearly 60-fold variance in the annual prevalence of major depression across countries is very similar to the pattern for cardiovascular disease, which shows a strong comorbidity for depression (4,5 Epidemiological studies have demonstrated significant inverse relationships between annual fish consumption and prevalence of major depression (4). Fish oil is the prime source for two key omega-3 (n-3) polyunsaturated fatty acids (PUFAs), eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA). Several laboratories have provided evidence that depressed patients have, on average, lower plasma levels of n-3 PUFAs than nondepressed controls; furthermore, there are relationships within these populations between severity of depressive symptoms and lower plasma levels of the n-3 PUFAs (3-6). What is more, all but one of four randomized controlled trials reported significant improvement in the treatment of depression following n-3 PUFA supplementation compared to nonsupplemented controls (6). Significant relationships between lower n...