Endocrine and cytokine correlates of major depression and dysthymia with typical or atypical features

Abstract

Depression has been associated with both suppression and enhancement of various aspects of immune functioning. It was of interest to determine whether cytokine alterations associated with depression, including interleukin-1 (IL-1␤) and interleukin-2 (IL-2), were related to the neurovegetative symptom profile or to the chronicity of the illness. Circulating ACTH, cortisol, norepinephrine (NE) and epinephrine levels, and production of IL-1␤ and IL-2 from mitogen-stimulated lymphocytes were assessed in classical major depression, atypical depression (ie, with reversed neurovegetative features), and dysthymia (chronic depression without comorbid major depression) with either typical or atypical profiles, as well as nondepressed control subjects. Among atypical depressives, plasma ACTH levels were elevated while cortisol was reduced relative to controls. Irrespective of neurovegetative profile, IL-1␤ production was increased in dysthymic patients, and was highly correlated with age-of-onset and duration of illness. In contrast, IL-2 production was reduced in each of the groups, although less so among atypical major depressives. Moreover, IL-2 production in the depressive groups was directly related to plasma NE levels. While neither depressed mood per se nor neurovegetative features accounted for this effect, it seemed likely that chronicity of illness or age-of-onset were associated with cytokine alterations. Given that circulating cytokines influence neuroendocrine functioning, and may affect neurovegetative features, a role for interleukins may exist with respect to the pathophysiology of certain subtypes of depression.

Differential Expression of Pentraxin 3 in Fibroblasts from Patients with Major Depression

“…This has not been described previously, to our knowledge. Abnormalities of cytokine activity in melancholia have been described (Anisman et al, 1999). However, the differences in PTX3 expression in the present experiment are not explainable by dissimilarities in plasma interleukins, since the fibroblasts from patients and controls were cultured in the same media.…”

Low tumor necrosis factor‐α levels predict symptom reduction during electroconvulsive therapy in major depressive disorder

“…Several studies have reported elevated TNFα levels in the blood and cerebrospinal fluid in patients with MDD (Dowlati et al., 2010; Goldsmith et al., 2016; Huang & Lee, 2007; Liu et al., 2012; Martinez, Garakani, Yehuda, & Gorman, 2012; Stelzhammer et al., 2011), but this finding was questioned in a recent meta‐analysis (Anisman et al., 1999). However, an elevated TNF‐α level has been somewhat associated with severe forms of depression (Anisman et al., 1999). Another meta‐analysis of inflammatory biomarkers in patients with MDD undergoing antidepressant treatment reported no decrease in the elevated baseline TNFα level.…”

DSM-IV Depression with Atypical Features: Is It Valid?

“…Unless atypical depression is differentiated from depressed patients with neither melancholic nor atypical features, applying atypical criteria could be a cumbersome way of saying melancholia is not present. McGinn et al (1996), Anisman et al (1999), Fountoulakis et al (2004), Bruder et al (2002, Stewart et al (1998), andJoyce et al (2002), partially answered the challenge of Parker et al (2002) (see Table 6). All studies compared depressed patients having atypical features with other depressed patients, five including an undifferentiated group having neither melancholic nor atypical features.…”

“…In addition, a concurrent comparison group with melancholic features would have allowed firmer inferences. Anisman et al (1999) investigated cortisol, ACTH, epinephrine, norepinephrine, and two cytokines (IL-1b and IL-2) in 74 depressed outpatients and 27 never depressed controls. The depressed subjects were assessed for the presence or absence of atypical features.…”