Correlation Between Serum Inflammatory Cytokines Levels And Antidepressant Efficacy In Depressed Patients

ObjectiveThe efficacy of antidepressant therapy also plays an important role in helping us understand the etiology and pathogenesis of depression.The relationship between depression and inflammatory cytokines also needs to be confirmed by systematic research at multiple levels.The complex changes of inflammatory cytokine network in the occurrence and development of depression and the multiple cascade effect of inflammatory cytokines on depression need to be further studied.This study provides a clinical basis for exploring the etiology and pathogenesis of depression,and to explore the relationship between antidepressant efficacy and serum inflammatory cytokines in patients with depression.MethodsAccording to the inclusion criteria and exclusion criteria,105 outpatients or inpatients with depression met the criteria who first visited Hangzhou from October2016 to October 2017 without antidepressant intervention and electroconvulsive therapy were selected.For the subjects included in the study,SSRIs drug monotherapy was selected for four weeks during the study period.Hamilton Depression Scale-17(HAMD-17)was used to evaluate the severity of depression before and after treatment.Theconcentrationsofseruminterleukin-1?(IL-1?),interleukin-2(IL-2),interleukin-6(IL-6)and tumor necrosis factor-?(TNF-?)were measured by enzyme-linked immunosorbent assay(ELISA)before and after treatment.According to the results of antidepressant treatment,HAMD-17 score reduction rate?50%is significantly effective group,HAMD-17 score reduction rate<50%is non-significant effective group,70 cases in significant effect group and 21 cases in non-significant effect group.Results105 patients with depression were treated with selective serotonin reuptake inhibitor(SSRIs)for 4 weeks,of which 14 cases were excluded according to the experimental requirements.The concentrations of IL-1?,IL-2,IL-6,TNF-?,HAMD-17score before treatment and after treatment were tested by independent sample t test.Before treatment,the concentrations of IL-1?(t?0.064,P>0.05),IL-2(t?0.460,P>0.05),IL-6(t?1.798,P>0.05),TNF-?(t?0.399,P>0.05)and HAMD-17 score(t?1.826,P>0.05),there was no significant difference between the two groups.After treatment,the concentrations of IL-1?(t?0.658,P>0.05)and IL-2(t?0.620,P>0.05),there was no significant difference in between the two groups.After treatment,between the two groups there were significant differences in the concentrations of IL-6(t?7.356,P<0.01),TNF-?concentration(t?12.959,P<0.01)and HAMD-17 score(t?17.695,P<0.01).After SSRIs drug treatment,the concentrations of IL-1?,IL-2,IL-6,TNF-?and HAMD-17 scores which has passed the paired sample t test were significantly lower than those before treatment,and the difference was statistically significant(P<0.01).The reduction rate of IL-6 and TNF-?in the effective group and the non-effective group were tested by two groups of independent samples t test.There were significant differences in IL-6 score reduction rate(t?7.202,P<0.01)and TNF-?score reduction rate(t?13.225,P<0.01).The correlation between IL-6 score reduction rate,TNF-?score reduction rate and HAMD-17 score reduction rate was analyzed.In the effective group,IL-6 score reduction rate(r?0.461,P<0.01)and TNF-?score reduction rate(r?0.397,P<0.05)were positively correlated with HAMD-17 score reduction rate,and the correlation was significant.There was no significant correlation between IL-6 score reduction rate(r?0.134,P>0.05)and TNF-?score reduction rate(r?0.123,P>0.05)and HAMD-17 score reduction rate in non-effective group.Linear regression analysis was carried out with HAMD-17 score reduction rate as dependent variable,IL-6 score reduction rate and TNF-?score reduction rate as independent variables in the effective group.TNF-?score reduction rate(R~2?0.258,P<0.01)had a positive predictive effect on HAMD-17 score reduction rate,but IL-6 score reduction rate(R~2?0.002,P>0.05)had no significant predictive effect on HAMD-17 score reduction rate.ConclusionThe levels of inflammatory cytokines such as IL-1?,IL-2,IL-6,TNF-?and HAMD-17 score were significantly decreased in patients with depression treated with SSRIs antidepressants.After antidepressant treatment with SSRIs,the decrease of IL-6 and TNF-?inflammatory cytokines is related to the improvement of depressive symptoms.the effective decrease of TNF-?level can predict the effect of antidepressant therapy.