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Levels of serum immunomodulators and alterations with electroconvulsive therapy in treatment-resistant major depression

Authors Zincir S, Öztürk PK, Bilgen AE, Izci F, Yükselir C

Received 18 February 2016

Accepted for publication 11 April 2016

Published 15 June 2016 Volume 2016:12 Pages 1389—1396

DOI https://doi.org/10.2147/NDT.S106652

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Prof. Dr. Roumen Kirov

Peer reviewer comments 2

Editor who approved publication: Dr Roger Pinder


Serkan Zincir,1 Pelin Öztürk,2 Ali Emrah Bilgen,3 Filiz İzci,4 Cihad Yükselir5

1Department of Psychiatry, Gölcük Military Hospital, Kocaeli, 2Psychiatry Clinic, Erenkoy Training and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, 3Department of Psychiatry, Etimesgut Military Hospital, Ankara, 4Department of Psychiatry, Istanbul Bilim University, Istanbul, 5Department of Psychiatry, Gulhane Military Medical Faculty, Ankara, Turkey

Abstract: Studies in recent years have indicated that neuroimmunological events and immune activation may have a place in the etiology of depression. It has been suggested from data that there is a causal relationship between activation of the immune system and excessive release of proinflammatory cytokines, such as interleukin 1 (IL-1), IL-6, and tumor necrosis factor-alpha (TNF-alpha), and the etiology of depression. Although the mechanism of action of electroconvulsive therapy (ECT) is unclear, there is evidence that it can reduce cytokines and immune system changes. In our study, we aimed to determine how levels of serum immunomodulators were affected by ECT in major depression patients. This study was conducted on 50 patients with treatment-resistant major depression. The data of the patients were compared with 30 healthy individuals with similar demographic characteristics. A clinical response occurred in the patients and at the end of therapy, IL-1, IL-6, TNF-alpha, IL-10, IL-4, and interferon-gamma levels were measured. The disease severity was assessed with the 17-item Hamilton Depression Rating Scale. Data analysis was performed using SPSS Version 15. Significant differences were determined between the patients with major depression and control group with respect to basal serum IL-1, IL-6, TNF-alpha, IL-10, IL-4, and interferon-gamma levels. ECT treatment was shown to reduce these differences. ECT may cause significant changes in the activity of the immune system. The consideration of the relationship between the immune endocrine neurotransmitter systems could contribute to new theories regarding the mechanism of antidepressant treatment and biology of depression.

Keywords: the pathophysiology of depression, the immune system, cytokines

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