The relationship between plasma cytokine levels and antidepressant response in patients with first-episode major depressive disorder

J Affect Disord. 2021 May 15;287:327-333. doi: 10.1016/j.jad.2021.03.036. Epub 2021 Mar 19.


Background: Cytokines are involved in the pathophysiology of major depressive disorder (MDD) and treatment response. Efforts have been made to identify inflammatory markers but results are often contradictory. The present study explored the plasma levels of multiple cytokines in first-episode MDD using a longitudinal design, with the aim to determine the involvement of cytokines in depression and identify the inflammatory markers.

Method: Fifty-four first-episode drug naïve MDD patients and 60 healthy controls (HCs) were enrolled in this study. The 17-item Hamilton Depression Rating Scale (HAMD-17) was administered and blood samples were collected at baseline and four-week posttreatment in MDD group, while blood samples were only collected once in HC group. Plasma levels of nineteen cytokines were examined by a multiplexed flow cytometric assay.

Results: Sixteen out of 19 cytokines levels in MDD group were significantly higher than those in HC group (all P < 0.05). After 4-week of antidepressant treatment, levels of the 14 cytokines elevated at baseline decreased to normal levels (all P < 0.05). Partial correlation showed that baseline level of interferon-inducible T cell alpha chemoattractant (ITAC) was negatively correlated with reduction in HAMD-17 score (r=-0.319, p=0.020), and multiple regression showed lower baseline ITAC level was associated with better treatment response (p = 0.020).

Limitation: The sample size was relatively small.

Conclusion: A range of cytokines were abnormal in patients with first-episode drug naïve MDD and most of the cytokines could be normalized after antidepressant treatment. Furthermore, baseline ITAC level could be a predictive factor of antidepressant response.

Keywords: Cytokine; association; depression; first-episode; interferon-inducible T cell alpha chemoattractant; predictive.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antidepressive Agents / therapeutic use
  • Cytokines
  • Depressive Disorder, Major* / drug therapy
  • Humans
  • Pharmaceutical Preparations*
  • Plasma


  • Antidepressive Agents
  • Cytokines
  • Pharmaceutical Preparations