Increased serum tumor necrosis factor-alpha levels and treatment response in major depressive disorder

Psychopharmacology (Berl). 2003 Dec;170(4):429-33. doi: 10.1007/s00213-003-1566-z. Epub 2003 Aug 30.

Abstract

Rationale: Over the last 15 years, an increasing body of evidence has suggested a causal relationship between depression and the immunological activation and hypersecretion of pro-inflammatory cytokines, such as interleukin-1, interleukin-6 and tumor necrosis factor-alpha (TNF-alpha). However, little is known about the probable relationship of serum TNF-alpha with major depressive disorder (MDD).

Objective: To assess whether serum TNF-alpha levels could be associated with the clinical course of MDD.

Subjects and methods: TNF-alpha and C-reactive protein (CRP) serum concentrations, erythrocyte sedimentation rate, and leukocyte count were measured in 26 MDD patients and in 17 controls. The measurements were repeated following 6 weeks of antidepressant treatment with selective serotonin re-uptake inhibitors. Psychopathological improvement and the severity of depression were evaluated with the Hamilton Depression Rating Scale (HAMD) and Beck Depression Inventory (BDI).

Results: On admission, serum TNF-alpha and leukocyte count were significantly higher in MDD patients compared to controls ( P<0.001 and P=0.005, respectively). With the antidepressant treatment, both HAMD and BDI scores decreased significantly (P<0.001 for both). Comparison of pre- and post-treatment measurements revealed that TNF-alpha, CRP, and leukocyte count decreased to levels comparable with those of the control subjects ( P<0.001, P=0.01, and P=0.01, respectively).

Conclusions: The results emphasized that some immunological parameters, such as CRP, leukocyte count and TNF-alpha, are significantly involved in the clinical course and treatment response in MDD. TNF-alpha in particular could be considered as a potential state marker in MDD.

MeSH terms

  • Adult
  • Blood Sedimentation
  • C-Reactive Protein / metabolism*
  • Case-Control Studies
  • Depressive Disorder / blood*
  • Depressive Disorder / classification
  • Depressive Disorder / drug therapy
  • Female
  • Humans
  • Leukocyte Count
  • Male
  • Serotonin Uptake Inhibitors / therapeutic use
  • Severity of Illness Index
  • Tumor Necrosis Factor-alpha / metabolism*

Substances

  • Serotonin Uptake Inhibitors
  • Tumor Necrosis Factor-alpha
  • C-Reactive Protein