Sertraline Decreases Serum Level of interleukin-6 (IL-6) in Hemodialysis Patients With Depression: Results of a Randomized Double-Blind, Placebo-Controlled Clinical Trial

Int Immunopharmacol. 2013 Nov;17(3):917-23. doi: 10.1016/j.intimp.2013.09.020. Epub 2013 Oct 11.

Abstract

Background: This study was designed to assess the effect of sertraline on serum concentrations of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), IL-10 and high-sensitivity C-reactive protein (hs-CRP) of depressed hemodialysis (HD) patients.

Methods: During a randomized, double-blind, placebo-controlled trial, fifty depressed HD patients were allocated to receive sertraline or placebo for 12 weeks. Patients' depression was assessed using Beck Depression Inventory-second edition (BDI-II). Biochemical parameters (hemoglobin, serum albumin, iron stores, etc.) and serum IL-6, IL-10, TNF-α, and hs-CRP levels were measured at baseline and at weeks 6 and 12 of the study.

Results: Sertraline significantly improved depression symptoms in 47.5% of the patients. Compared with placebo, serum levels of IL-6 significantly decreased (P<0.01) in the sertraline group at week 12 of the study. Although serum level of TNF-α decreased and serum level of IL-10 increased in sertraline group at week 12 versus initiation of the study, no significant differences were found between sertraline and placebo groups. Serum hs-CRP did not display differences neither for inter- nor intra-group comparisons. Hemoglobin and serum albumin concentrations were significantly lower at week 12 in the placebo versus sertraline group (P=0.012 and P=0.006, respectively). No significant differences were observed in the inflammatory mediators between responders and non-responders to sertraline.

Conclusions: Compared with placebo, sertraline significantly decreased serum level of IL-6. The anti-inflammatory effect of sertraline was independent to its efficacy for depression treatment. Sertraline could be a promising strategy to reduce the systemic inflammation and to treat depression in HD patients.

Keywords: Depression; Hemodialysis; IL-10; IL-6; Sertraline; TNF-α.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antidepressive Agents / pharmacology*
  • Antidepressive Agents / therapeutic use
  • Cytokines / blood*
  • Depression / blood*
  • Depression / drug therapy
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Renal Dialysis*
  • Sertraline / pharmacology*
  • Sertraline / therapeutic use

Substances

  • Antidepressive Agents
  • Cytokines
  • Sertraline