Defective Inflammatory Pathways in Never-Treated Depressed Patients Are Associated with Poor Treatment Response

Shariful A. Syed, Eléonore Beurel, David A. Loewenstein, Jeffrey A. Lowell, W. Edward Craighead, Boadie W. Dunlop, Helen S. Mayberg, Firdaus Dhabhar, W. Dalton Dietrich, Robert W. Keane, Juan Pablo de Rivero Vaccari, Charles B. Nemeroff

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

Inflammation has been involved in the pathophysiology and treatment response of major depressive disorder (MDD). Plasma cytokine profiles of 171 treatment-naive MDD patients (none of the MDD patients received an adequate trial of antidepressants or evidence-based psychotherapy) and 64 healthy controls (HCs) were obtained. MDD patients exhibited elevated concentrations of 18 anti- and proinflammatory markers and decreased concentrations of 6 cytokines. Increased inflammasome protein expression was observed in MDD patients, indicative of an activated inflammatory response. The plasma of MDD patients was immunosuppressive on healthy donor peripheral blood mononuclear cells, inducing reduced activation of monocytes/dendritic cells and B cells and reduced T cell memory. Comparison between 33 non-responders and 71 responders at baseline and 12 weeks revealed that after treatment, anti-inflammatory cytokine levels increase in both groups, whereas 5 proinflammatory cytokine levels were stabilized in responders, but continued to increase in non-responders. MDD patients exhibit remodeling of their inflammatory landscape. Treatment-naive MDD patients have increased levels of pro- and anti-inflammatory markers, but overall the balance shifts toward immunosuppression of immune cells. Consistent with these findings, absence of response to antidepressant treatments has been associated with defective anti-inflammatory response.

Original languageEnglish (US)
Pages (from-to)914-924.e3
JournalNeuron
Volume99
Issue number5
DOIs
StatePublished - Sep 5 2018

Keywords

  • cytokines
  • defective anti-inflammatory pathway
  • inflammasome
  • major depressive disorder
  • PBMC
  • T cell memory
  • treatment naive

ASJC Scopus subject areas

  • Neuroscience(all)

Fingerprint Dive into the research topics of 'Defective Inflammatory Pathways in Never-Treated Depressed Patients Are Associated with Poor Treatment Response'. Together they form a unique fingerprint.

  • Cite this