Possible Clinical Implications Of Immune Changes In Depression

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The immunologic consequences of major depression and their possible clinical relevance to infectious diseases have not been delineated (Stein et al., 1991). Major depression has been associated with alterations in the distribution of T cell subsets and with declines in nonspecific measures of immune function, such as NK activity and mitogen-induced lymphocyte proliferation. The clinical significance of these immunologic findings is uncertain because the in vitro assays employed were non-specific and thus not directly relevant to specific disease endpoint.

To address these issues, we have recently examined the effect of major depression on varicella zoster virus (VZV)-specific cellular immunity (Irwin, Costlow, Williams, Artin, Levin, Hayward, & Oxman, 1998). The frequency of cells in the peripheral blood capable of proliferating in response to VZV antigen (VZV-responder cell frequency, VZV-RCF) was determined in patients with major depression and in age-and gender-matched normal controls. In addition, we evaluated VZV-RCF in a group of older adults to determine whether the decline in VZV-RCF observed in major depression was comparable in magnitude to that typically found in older persons who are known to be at increased risk of developing HZ.

Comparison of depressed subjects with age- and gender-matched normal controls demonstrated that the mean age and gender distribution were similar in the two groups. The mean age of the depressed subjects was 51.3 ± 15.7 years old and that of the matched normal controls was 51.4 ± 17.2 years. There were 7 men and 4 women in each group. As shown in Figure 5, VZV-specific responder cell frequency was significantly lower in the subjects with major depression than in matched normal controls.

To assess the possible clinical significance of the reduced VZV-RCF observed in the depressed subjects, VZV-RCF values in the depressed subjects were compared to

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