Lymphocyte function in major depression

Abstract

Immunologic function as measured by lymphocyte response to phytohemagglutinin (PHA) mitogen was evaluated in 8 psychiatric inpatients. All were less than 45 years of age and had a DSM-III diagnosis of major depression. When patient's immunologic responses were compared with healthy age- and sex-matched controls, a significant increase in PHA mitogen stimulation was observed in the depressed group. Further, a significantly greater variance in PHA response was observed in the patients compared with controls. The literature on depression and immunity is reviewed and the clinical implications of our findings are discussed.

Depression and immunocompetence: A review of the literature.

“…For example, Altshuler et al (1989) assessed lymphocyte function in a group of depressives that included both bipolar and unipolar patients. Results revealed a lack of differences between depressed patients and controls in lymphocyte responses to one dose of mitogen, and when a higher dose was used, depressed patients exhibited higher lymphocyte responses than controls.…”

“…Reports of reduced lymphocyte function among depressed patients is a common finding in studies that have included older patients or in studies in which patients were older than controls (e.g., Calabrese et al, 1986;Kronfol & House, 1989;Kronfol, House, Silva, Greden, & Carroll, 1986;Kronfol, Silva, Greden, Dembinski, & Carroll, 1982;Kronfol et al, 1983;Kronfol et al, 1982;Syvalahti et al, 1985). Studies comparing young, depressed patients with age-matched controls do not find differences in lymphocyte function (e.g., Altshuler et al, 1989). In addition, studies including quantitative measures suggest that altered leukocyte numbers among the depressed may be age-related as well (Murphy et al, 1987;Schleifer et al, 1989;Targum et al, 1989).…”

“…Studies reviewed thus far suggest that a variety of immune processes may be reduced during clinical depression, but that reduced lymphocyte responsiveness is the most consistent immune aberration noted among the clinically depressed. However, some recent studies have reported normal lymphocyte function in depressed patients (Albrecht, Helderman, Schlesser, & Rush, 1985; Altshuler, Plaeger-Marshall, Richeimer, Daniels, & Baxter, 1989; Darko et al, 1989; Schleifer, Keller, Bond, Cohen, & Stein, 1989; Schleifer, Keller, Siris, Davis, & Stein, 1985; Sengar, Waters, Dunne, & Bouer, 1982). Close examination of these studies reveal patterns that offer insight into those conditions under which depressives may be more prone to exhibit reduced lymphoproliferation.…”

“…Of interest as well would be studies that identify neuroendocrine mediators involved in the relationship between depression and changes in immune processes. Although cortisol has been widely proposed as the key hormone responsible for immune disarray during depression, several recent studies challenge this claim (e.g., Altshuler et al, 1989; Irwin et al, 1988; Kronfol et al, 1986; Nerozzi et al, 1989; Schleifer et al, 1989), and new evidence has emerged implicating humoral factors such as prostaglandins and prolactin (Calabrese et al, 1986; Darko et al, 1989). Clearly, innovative approaches pursuing these leads will help uncover such mechanisms.…”

Serological observations in patients suffering from acute manic episodes

“…Similarly, antibody dependent cellular cytotoxic activity against red blood cells has been demonstrated to be reduced by cytotoxic cells from manic patients (Barsi et al, 1989). Others, however, demonstrated raised lymphocyte proliferation to mitogens by lymphocytes derived from manic patients (Tsai et al, 1999) and those suffering from major depression (Altshuler et al, 1989). Furthermore, manic or depressed patients exhibit histone variant synthesis patterns intermediate between resting and cycling cells, different to control cells that exhibit resting patterns (Sourlingas et al, 1989).…”