Impaired Lymphocyte Stimulation by Mitogens in Severely Depressed Patients | The British Journal of Psychiatry | Cambridge Core (original) (raw)

Abstract

To investigate the relationships between the immune apparatus, major depression, and HPA-axis and noradrenergic activity, the authors measured the lymphocyte stimulation responses to the mitogens phytohaemagglutinin (PHA), pokeweed mitogen (PWM) and concanavalin A (CON A), post-dexamethasone Cortisol (DST) values and 3-methoxy-4-hydroxyphenylglycol (MHPG) excretion in 24-hour urine samples from 48 patients. We found that lymphocyte responses to PHA and PWM in melancholic and psychotic depressives were significantly lower than in minor depressives. The lymphocyte responses to PHA, PWM and CON A showed significantly negative correlations with age, DST results and HRSD score. Responses to PHA were significantly negatively correlated with MHPG excretion. Up to ±33% of the variance in the three mitogenic lymphocyte responses could be explained by canonical correlation with age, DST results and MHPG values.

References

Albrecht, J., Helderman, J. H., Schlesser, M. A., et al (1985) A controlled study of cellular immune function in affective disorders before and during somatic therapy. Psychiatry Research, 15, 185–193.Google Scholar

Alexopoulos, G. S., Young, R. C., Kocsis, J. H., et al (1984) Dexamethasone suppression test in geriatric depression. Biological Psychiatry, 19, 1567–1571.Google ScholarPubMed

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn). Washington DC: APA.Google Scholar

Beisel, W. R., Edelman, R., Nauss, K., et al (1981) Single-nutrient effects on immunologic functions. Journal of the American Medical Association, 245, 53–58.CrossRefGoogle ScholarPubMed

Besodovsky, H., del Rey, A. & Sorkin, E. (1983) The immune response evokes changes in brain noradrenergic neurons. Science, 221, 564–566.CrossRefGoogle Scholar

Bistrian, B. R., Blackburn, G. L., Schrimshaw, N. S., et al (1975) Cellular immunity in semi-starved states in hospitalized adults. American Journal of Clinical Nutrition, 28, 1148–1155.CrossRefGoogle Scholar

Brooks, W. H., Cross, R. J., Roszman, T. L., et al (1982) Neuro immuno modulation: neural anatomical basis for impairment and facilitation. Annals of Neurology, 12, 56–67.Google Scholar

Calabrese, J. R., Kling, M. A. & Gold, P. W. (1987) Alterations in immunocompetence during stress, bereavement, and depression: focus on neuroendocrine regulation. American Journal of Psychiatry, 144, 1123–1134.Google Scholar

Carroll, B. J. (1980) Clinical application of neuro-endocrine research in depression. In Handbook of Biological Psychiatry, Part III (eds van Praag, H. M., Lader, M. H. & Sachar, E. J.), pp. 179–193. New York: Marcel Dekker.Google Scholar

Claes, J. H. (1969) Bepaling van creatinine en creatine. In Klinische Chemie (ed. Claes, J. H.), pp. 129–131. Leuven: L. Wouters.Google Scholar

Cross, R. I., Brooks, W. H., Roszman, T. L., et al (1982) Hypothalamic–immune interactions: effect of hypophysectomy on neuroimmunomodulation. Journal of the Neurological Sciences, 52, 557–566.CrossRefGoogle Scholar

Fein berg, M. & Carroll, B. J. (1984) Biological markers for endogenous depression: effects of age, severity of illness, weight loss and polarity. Archives of General Psychiatry, 41, 1080–1085.CrossRefGoogle Scholar

Filser, J. G., Müller, W. E. & Beckmann, H. (1986) Should plasma or urinary MHPG be measured in psychiatric research? A critical comment. British Journal of Psychiatry, 148, 95–97.Google Scholar

Garfinkel, P. E., Warsch, J. J. & Stancer, H. C. (1979) Depression: new evidence in support of biological differentiation. American Journal of Psychiatry, 136, 535–539.Google Scholar

Hamilton, M. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–61.Google Scholar

Keller, S. E., Schleifer, S. J., Sherman, J., et al (1981) Comparison of a simplified whole blood and isolated lymphocyte stimulation technique. Immunological Communication, 10, 417–431.Google Scholar

Kishimoto, S., Tomino, S., Inowata, K., et al (1978) Age-related changes in the subsets and functions of human T lymphocytes. Journal of Immunology, 121, 1773–1780.CrossRefGoogle ScholarPubMed

Kronfol, Z., Silva, J., Greden, J., et al (1983) Impaired lymphocyte function in depressive illness. Life Sciences, 33, 241–247.Google Scholar

Kronfol, Z. & House, D. (1985) Depression, hypothalamic–pituitary–adrenocortical activity, and lymphocyte function. Psychopharmacology Bulletin, 21, 476–478.Google Scholar

Kronfol, Z., House, J. D., Silva, J., et al (1986) Depression, urinary free Cortisol excretion and lymphocyte function. British Journal of Psychiatry, 148, 70–73.Google Scholar

Lewis, D. A., Pfohl, B., Schlechte, J., et al (1984) Influence of age on the Cortisol response to dexamethasone. Psychiatry Research, 13, 213–220.Google Scholar

Maas, J. W., Koslow, S. H., Davis, J., et al (1987) Catecholamine metabolism and disposition in healthy and depressed subjects. Archives of General Psychiatry, 44, 337–344.Google Scholar

Maes, M., de Ruyter, M., Hobin, P., et al (1986a) The dexamethasone suppression test, the Hamilton Depression Rating Scale and the DSM–III depression categories. Journal of Affective Disorders, 10, 207–214.Google Scholar

Maes, M., de Ruyter, M., & Suy, E. (1986b) The importance of creatinine flow, age and 24 hr urinary output in the interpretation of the MHPG flow. Journal of Affective Disorders, 10, 221–225.Google Scholar

Maes, M., de Ruyter, M., & Suy, E. (1987) Prediction of subtype and severity of depression by means of dexamethasone suppression test, l-tryptophan/competing amino acids ratio, and MHPG flow. Biological Psychiatry, 22, 177–188.Google Scholar

Maes, M., Vandewoude, M., Maes, L., et al (1989) The TRH test in depression: revised – Part I. The TSH responses, effects of diagnostic categories, severity of illness, thyroid hormones, postdexamethasone Cortisol values, age, sex-hormones, catecholaminergic turnover and nutritional status. Journal of Affective Disorders, 16, 203–213.Google Scholar

McGillis, J. M., Hall, N. R., Vahouny, G. V., et al (1985) Thymosin fraction 5 causes increased serum corticosterone in rodents in vivo. Journal of Immunology, 134, 3952–3955.Google Scholar

Moleman, P. & Borstrok, J. J. M. (1982) Analysis of 3-methoxy-4-hydroxyphenylglycol by high-performance liquid chromatography and electrochemical detection. Journal of Chromatography, 227, 391–405.Google Scholar

Oppenheim, J., Dougherty, S. & Chan, S. (1975) Use of lymphocyte transformation to assess clinical disorders. In Laboratory Diagnosis of Immunological Disorders (eds Vyas, G., Stites, D. & Brecher, G.). New York: Grune and Stratton.Google Scholar

Oxenkrug, G. F., Pomara, N., McIntyre, I. M., et al (1984) Aging and Cortisol resistance to suppression by dexamethasone: a positive correlation. Psychiatry Research, 10, 125–150.CrossRefGoogle Scholar

Pfeifer, M. A., Weinberg, C. R., Cook, D., et al (1983) Differential changes of autonomic nervous system function with age in man. American Journal of Medicine, 75, 249–258.Google Scholar

Portaro, J. K., Glick, G. I. & Zighelboim, J. (1978) Population immunology: age and immune cell parameters. Clinical Immunology and Immunopathology, 11, 339–345.CrossRefGoogle ScholarPubMed

Ritchie, A. W. S., Oswald, I., Micklem, H. S., et al (1983) Circadian variation of lymphocyte subpopulation: a study with monoclonal antibodies. British Medical Journal, 286, 1773–1775.Google Scholar

Roitt, I., Brostoff, J. & Male, D. (1985) Immunology. New York: Gower Medical Publishing.Google Scholar

Schleifer, S. J., Keller, S. E., Meyerson, A. T., et al (1984) Lymphocyte function in major depressive disorder. Archives of General Psychiatry, 41, 484–486.Google Scholar

Schleifer, S. J., Keller, S. E., Siris, S. G., et al (1985) Depression and immunity: lymphocyte function in ambulatory depressed patients, hospitalized schizophrenic patients, and patients hospitalized for herniorrhaphy. Archives of General Psychiatry, 42, 129–133.Google Scholar

Spitzer, R. L., Williams, J. B. W. & Gibbon, M. (1985) Structured Clinical Interview for DSM–III, Patient Version. New York: Biometrics Research Department, New York State Psychiatric Institute.Google Scholar

de Villiers, A. S., Russell, U. A., Carstens, M. E., et al (1987) Noradrenergic function and hypothalamic–pituitary–adrenal axis activity in primary unipolar major depressive disorder. Psychiatry Research, 22, 127–140.Google Scholar

Williams, J. B. W. & Spitzer, R. K. (1982) Research Diagnostic Criteria and DSM–III: an annotated comparison. Archives of General Psychiatry, 39, 1283–1289.Google Scholar