Journal of Shandong University (Health Sciences) ›› 2018, Vol. 56 ›› Issue (6): 51-57.doi: 10.6040/j.issn.1671-7554.0.2017.261

Previous Articles     Next Articles

Serum level of hs-CRP in patients with depression and its predictive role for the efficiency of antidepressants

WANG Dan1, YANG Xiaohua2, ZHENG Yunshao2, KAN Weijing1, XUN Guanglei2   

  1. 1. Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. Department of Psychiatry, Shandong Mental Health Center, Jinan 250014, Shandong, China
  • Published:2022-09-27

PDF (PC)

55

Abstract: Objective To explore the changes of high sensitivity C reactive protein(hs-CRP)level before and after antidepressant treatment, as well as the predictive role of hs-CRP level at baseline for the efficiency of antidepressants. Methods A total of 61 patients with depression(study group)were randomized into the sertraline subgroup(n=30)and duloxetine subgroup(n=31). At baseline and the end of 8-week treatment, the serum level of hs-CRP was measured, and Hamilton Depression Scale-17 items(HAMD-17)were evaluated. Additionally, serum hs-CRP level was measured in 32 well-matched healthy controls(control group)and re-measured 8 weeks later. Results At baseline, the serum level of hs-CRP was higher in the study group than in control group, and it decreased significantly after 8-week treatment but was still significantly higher than that in the control group at the endpoint(P<0.05). Serum hs-CRP level in the study group was positively correlated with HAMD-17 score at baseline and endpoint(P<0.05). In the duloxetine subgroup, the effective rate and reduction rate of HAMD-17 in patients with higher level of baseline hs-CRP(≥3 mg/L)were significantly higher than those in patients with lower baseline hs-CRP(<3 mg/L)(P<0.05). Moreover, in patients with higher baseline hs-CRP level, the effective rate of duloxetine was significantly higher than that of sertraline(P<0.05). Binary Logistic regression analysis indicated that baseline hs-CRP level and subgroup × baseline hs-CRP level 山 东 大 学 学 报 (医 学 版)56卷6期 -王丹,等.抑郁症患者血清hs-CRP水平变化及其对抗抑郁药疗效的预测作用 \=-entered the regression equation of efficacy. Factorial design ANOVA illustrated that interaction between antidepressant and baseline hs-CRP level had certain effects on the efficacy of treatment(P<0.05). Conclusion Elevated inflammatory response is involved in the pathophysiology of depression. Serum hs-CRP level may partly reflect the severity of depression. Depressive patients with high baseline hs-CRP level are more likely to respond to duloxetine. Validation in a larger sample is warranted.

Key words: Depression, High sensitivity C reactive protein, Inflammation, Duloxetine, Sertraline

CLC Number: 

  • R749.4
[1] Dowlati Y, Herrmann N, Swardfager W, et al. A meta-analysis of cytokines in major depression[J]. Biol Psychiatry, 2010, 67(5): 446-457.
[2] Liu Y, Ho RC, Mak A. Interleukin(IL)-6, tumour necrosis factor alpha(TNF-α)and soluble interleukin-2 receptors(sIL-2R)are elevated in patients with major depressive disorder: a meta-analysis and meta-regression[J]. J Affect Disord, 2012, 139(3): 230-239.
[3] Papakostas GI, Shelton RC, Kinrys G, et al. Assessment of a multi-assay, serum-based biological diagnostic test for major depressive disorder: a pilot and replication study[J]. Mol Psychiatry, 2013, 18(3): 332-339.
[4] 张明园, 何燕玲. 精神科评定量表手册[M]. 2版. 长沙: 湖南科学技术出版社, 2015: 142-148.
[5] Maes M. Evidence for an immune response in major depression: a review and hypothesis[J]. Prog Neuropsychopharmacol Biol Psychiatry, 1995, 19(1): 11-38.
[6] Vreeburg SA, Hoogendijk WJ, van Pelt J, et al. Major depressive disorder and hypothalamic-pituitary-adrenal axis activity: results from a large cohort study[J]. Arch Gen Psychiatry, 2009, 66(6): 617-626.
[7] Licht CM, de Geus EJ, Zitman FG,et al. Association between major depressive disorder and heart rate variability in the Netherlands Study of Depression and Anxiety(NESDA)[J]. Arch Gen Psychiatry, 2008, 65(12): 1358-1367.
[8] Marsland AL, Gianaros PJ, Abramowitch SM, et al. Interleukin-6 covaries inversely with hippocampal grey matter volume in middle-aged adults[J]. Biol Psychiatry, 2008, 64(6): 484-490.
[9] Blank T, Detje CN, Spieß A, et al. Brain endothelial- and epithelial-specific interferon receptor chain 1 drives virus-induced sickness behavior and cognitive impairment[J]. Immunity, 2016, 44(4): 901-912.
[10] Khairova RA, Machado-Vieira R, Du J, et al. A potential role for pro-inflammatory cytokines in regulating synaptic plasticity in major depressive disorder[J]. Int J Neuropsychopharmacology, 2009, 12(4): 561.
[11] Dantzer R, O’Connor JC, Freund GG, et al. From inflammation to sickness and depression: when the immune system subjugates the brain[J]. Nat Rev Neurosci, 2008, 9(1): 46-56.
[12] Shelton RC, Claiborne J, Sidoryk-Wegrzynowicz M, et al. Altered expression of genes involved in inflammation and apoptosis in frontal cortex in major depression[J]. Mol Psychiatry, 2011, 16(7): 751-762.
[13] Valkanova V, Ebmeier KP, Allan CL. CRP, IL-6 and depression: a systematic review and meta-analysis of longitudinal studies[J]. J Affect Disord, 2013, 150(3): 736-744.
[14] Wium-Andersen MK, Ørsted DD, Nielsen SF, et al. Elevated C-reactive protein levels, psychological distress, and depression in 73131 individuals[J]. JAMA Psychiatry, 2013, 70(2): 176-184.
[15] Lopresti AL, Maker GL, Hood SD, et al. A review of peripheral biomarkers in major depression: the potential of inflammatory and oxidative stress biomarkers[J]. Prog Neuropsychopharmacol Biol Psychiatry, 2014, 48(1433): 102-111.
[16] Vogelzangs N, Duivis HE, Beekman AT, et al. Association of depressive disorders, depression characteristics and antidepressant medication with inflammation[J]. Transl Psychiatry, 2012, 2(2): e79. doi: 10.1038/tp.2012.8.
[17] Copeland WE, Shanahan L, Worthman C, et al. Cumulative depression episodes predict later C-reactive protein levels: a prospective analysis[J]. Biol Psychiatry, 2012, 71(1): 15-21.
[18] Zalli A, Jovanova O, Hoogendijk WJ, et al. Low-grade inflammation predicts persistence of depressive symptoms[J]. Psychopharmacology(Berl), 2016, 233(9): 1669-1678.
[19] Almeida OP, Norman PE, Allcock R, et al. Polymorphisms of the CRP gene inhibit inflammatory response and increase susceptibility to depression: the Health in Men Study[J]. Int J Epidemiol, 2009, 38(4): 1049-1059.
[20] Dieperink E, Willenbring M, Ho SB. Neuropsychiatric symptoms associated with hepatitis C and interferon alpha: a review[J]. Am J Psychiatry, 2000, 157(6): 867-876.
[21] Raison CL, Rutherford RE, Woolwine BJ, et al. A randomized controlled trail of the tumor necrosis factor antagonist infliximab for treatment-resistant depression: the role of baseline inflammatory biomarkers[J]. JAMA Psychiatry, 2013, 70(1): 31-41.
[22] Miller AH, Maletic V, Raison CL. Inflammation and its discontents: the role of cytokines in the pathophysiology of major depression[J]. Biol Psychiatry, 2009, 65(9): 732-741.
[23] Chavda N, Kantharia ND, Jaykaran. Effects of fluoxetine and escitalopram on C-reactive protein in patients of depression[J]. J Pharmacol Pharmacother, 2011, 2(1): 11-16.
[24] Felger JC, Li Z, Haroon E, et al. Inflammation is associated with decreased functional connectivity within corticostriatal reward circuitry in depression[J]. Mol Psychiatry, 2016, 21(10): 1358-1365.
[25] Mowla A, Dastgheib SA, Razeghian Jahromi L. Comparing the effects of sertraline with duloxetine for depression severity and symptoms: a double-blind, randomized controlled trial[J]. Clin Drug Investig, 2016, 36(7): 539-543.
[26] Uher R, Tansey KE, Dew T, et al. An inflammatory biomarker as a differential predictor of outcome of depression treatment with escitalopram and nortriptyline[J]. Am J Psychiatry, 2014, 171(12): 1278- 1286.
[1] HAO Yue-Wei, LIU Xue-Ping, ZHAO Ting-Ting, ZHENG Min, WANG Yi-Bing. Relationship between the COX-2 gene polymorphisms and atherothrombotic ischemic stroke [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2209, 47(6): 95-98.
[2] XU Ning-Yu, WANG Lei, HAO En-Kui, SU Guo-Hai. Effects of atorvastatin given before acute PCI on inflammatory mediators and left ventricular function in STEMI [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2209, 47(6): 69-72.
[3] ZHANG Bingfen, ZHOU Shenghong, WANG Zhe. Trillium Saponins ameliorates pulmonary fibrosis in rats by inhibiting TGF-β/Smad3 and Wnt/β-catenin signaling pathways [J]. Journal of Shandong University (Health Sciences), 2022, 60(8): 23-29.
[4] LI Rui, SHI Cunxian, YU Cuicui. Effects of dexmedetomidine on intestinal-related injury during cardiopulmonary bypass [J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 83-88.
[5] LIU Yan, ZHANG Man, JIANG Chaoyang, BIAN Shu, DU Aijia, CHEN He. LncRNA-HOTAIR regulates migration of macrophages via H3K27me3 pathway [J]. Journal of Shandong University (Health Sciences), 2022, 60(6): 1-9.
[6] WU Yujie, ZHANG Mingquan, JI Yongli, ZHAO Lu, WANG Yue, CHEN Shasha. Effects of Hanjingtang and its disassembled prescriptions on serum inflammatory factors, vascular endothelial function and fibrosis in hypertensive rats with cold coagulation syndrome [J]. Journal of Shandong University (Health Sciences), 2022, 60(6): 10-18.
[7] ZHANG Xiufang, LI Peizheng, ZHANG Bohan, SUN Congcong, LIU Yiming. Protective effect and mechanism of growth differentiation factor-15 in LPS-induced models of Parkinsons disease [J]. Journal of Shandong University (Health Sciences), 2022, 60(5): 1-7.
[8] ZHAO Hailong, WANG Hao, FANG Yuqing, MAO Fei, ZHAO Zhangning, TIAN Xiangqi, XU Xinrong, WANG Min, LI Xiuhua. Efficacy of additional idebenone in the treatment of 34 patients with Parkinsons disease with depression [J]. Journal of Shandong University (Health Sciences), 2022, 60(4): 38-44.
[9] SONG Luoqing, ZHOU Guoyu, YE Xiang, LU Mei, ZHAO Xinjing. A case report of misdiagnosed cerebral amyloid angiopathy-related inflammation and literature review [J]. Journal of Shandong University (Health Sciences), 2022, 60(4): 119-122.
[10] ZHAO Xuan, LI Xiaopeng, LI Jian, TIAN Bin, WANG Guangjun. Therapeutic effects of auricular points sticking with magnetic beads combined with repeated transcranial magnetic stimulation on post-stroke depression [J]. Journal of Shandong University (Health Sciences), 2022, 60(1): 65-70.
[11] FU Wenhao, LI Jiajia, FANG Feng, LI Shixue. Depression status and associated factors among informal caregivers of patients with critical illness [J]. Journal of Shandong University (Health Sciences), 2022, 60(1): 71-77.
[12] Zhaoying ZHANG,Chunhong MA. Immunomodulatory effects of bile acid in hepatointestinal diseases [J]. Journal of Shandong University (Health Sciences), 2021, 59(9): 30-36.
[13] SUN Fuyun, WANG Weipeng, ZHANG Huihui, GENG Yan, AN Xiaoxia, LI Shuangshuang, ZHANG Binbin. Correlation among personality traits and depression, anxiety symptoms in patients after colorectal cancer resection [J]. Journal of Shandong University (Health Sciences), 2021, 59(7): 91-96.
[14] Ping LIU,Yuwen SONG,Ping WANG,Guangwei TIAN,Fengjie ZHENG,Li LYU,Jiaojiao DU,Jing ZHANG,Xianghua ZHUANG,Shihong CHEN. Correlation between vitamin D deficiency and depression in patients with type 2 diabetes mellitus [J]. Journal of Shandong University (Health Sciences), 2021, 59(6): 51-56,102.
[15] Xi ZHOU,Muhan HUANG,Yujie REN,Yang QIU. SARS-CoV-2 infection, innate immunity and inflammatory response [J]. Journal of Shandong University (Health Sciences), 2021, 59(5): 15-21.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd