Immune system dysregulation in adolescent major depressive disorder

New York University School of Medicine, NYU Child Study Center, NY 10016, United States.
Journal of Affective Disorders (Impact Factor: 3.38). 10/2008; 115(1-2):177-82. DOI: 10.1016/j.jad.2008.07.022
Source: PubMed


A large body of evidence suggests that immune system dysregulation is associated with Major Depressive Disorder (MDD) in adults. This study extends this work to adolescent MDD to examine the hypotheses of immune system dysregulation in adolescents with MDD, as manifested by significantly: (i) elevated plasma levels of cytokines (interferon [IFN]-gamma, tumor necrosis factor-alpha, interleukin [IL]-6, IL-1beta, and IL-4); and (ii) Th1/Th2 cytokine imbalance shifted toward Th1 as indexed by increased IFN-gamma/IL-4.
Thirty adolescents with MDD (19 females; 13 medication-free/naïve; ages 12-19) of at least 6 weeks duration and a minimum severity score of 40 on the Children's Depression Rating Scale-Revised, and 15 healthy comparisons (8 females), group-matched for age, were enrolled. Plasma cytokines were examined using enzyme-linked immunosorbent assay. Mann-Whitney test was used to compare subjects with MDD and controls.
Adolescents with MDD had significantly elevated plasma IFN-gamma levels (3.38+/-11.8 pg/ml versus 0.37+/-0.64 pg/ml; p<0.003), and IFN-gamma/IL-4 ratio (16.6+/-56.5 versus 1.76+/-2.28; p=0.007). A trend for IL-6 to be elevated in the MDD group was also observed (1.52+/-2.88 pg/ml versus 0.49+/-0.90 pg/ml; p=0.09). Importantly, findings remained evident when medicated subjects were excluded.
Findings suggest that immune system dysregulation may be associated with adolescent MDD, with an imbalance of Th1/Th2 shifted toward Th1, as documented in adult MDD. Larger studies with medication-free adolescents should follow.

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Available from: Rachel G Klein
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    • "As suggested by the results of meta analysis studies, although the association of pro-inflammatory cytokines and depression in adults has been demonstrated yet the same remains to be demonstrated extensively in adolescent and pediatric population. Immune system dysfunction in depression has been observed across different age groups (Penninx et al., 2003; Danese et al., 2008; Viscogliosi et al., 2011) including adolescents (Brambilla et al., 2004; Gabbay et al., 2009a, 2009b; Miller and Cole 2012; Henje Blom et al., 2012; Mcdade et al., 2013). There is also a gender difference. "
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