Increased serum tumor necrosis factor-alpha levels and treatment response in major depressive disorder
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- Tuglu, C., Kara, S.H., Caliyurt, O. et al. Psychopharmacology (2003) 170: 429. doi:10.1007/s00213-003-1566-z
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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-α). However, little is known about the probable relationship of serum TNF-α with major depressive disorder (MDD).
To assess whether serum TNF-α levels could be associated with the clinical course of MDD.
Subjects and methods
TNF-α 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).
On admission, serum TNF-α 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-α, 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).
The results emphasized that some immunological parameters, such as CRP, leukocyte count and TNF-α, are significantly involved in the clinical course and treatment response in MDD. TNF-α in particular could be considered as a potential state marker in MDD.