More MS news articles for July 2001

Depression Care Modifies Interferon-Gamma Production in Multiple Sclerosis

A DGReview of :"Treatment of Depression Is Associated With Suppression of Nonspecific and Antigen-Specific T H 1 Responses in Multiple Sclerosis"
Archives of Neurology

By Elda Hauschildt

Depression is linked with interferon gamma (IFN-gamma) production in patients with multiple sclerosis (MS). Treatment of depression is associated with a reduction in non-specific and antigen-specific IFN-gamma production.

"These novel findings suggest that treating depression may be an important disease-modifying component in the treatment and management of relapse-remitting MS," explain researchers from the University of California, San Francisco.

"Depression is associated with increased IFN-gamma production, and IFN-gamma production can be down-regulated by treating depression."

Investigators add that the observed relationship between IFN-production, depression and treatment of depression may have "particular salience for MS patients as IFN-gamma has been implicated as a major factor in the pathophysiology of this disease."

Researchers conducted a randomised, comparative outcome trial that included three 16-week treatments for depression.

Three treatment programs included both behavioural and pharmacological treatments: individual cognitive behavioural therapy designed to improve coping skills, group psychotherapy designed to provide social support and psycho-pharmacological therapy based on the antidepressant, sertraline.

Of 14 MS patients with major depressive disorder who participated, 10 (71 percent) were women. Average age was 47.4 years. Mean time since MS diagnosis was 11.3 years. Mean Expanded Disability Status Range was 3.6.

Participants were assessed at baseline, week eight and at the end of treatment. Variability in immune assays was controlled for using eight non-depressed, healthy subjects enrolled at the same time as MS patients were enrolled.

Investigators used the Beck Depression Inventory to assess depression. They also measured IFN-gamma production by peripheral blood mononuclear cells.

"Over the course of treatment for depression, decreases in levels of depression were associated with decreases in levels of IFN-gamma production" among the MS patients, the researchers report.

There were no changes in IFN-gamma production or in depression among the healthy controls.

"Although the manipulation of depression through treatment supports the argument that depression can cause changes in IFN-gamma production, these findings do not rule out the possibility that IFN-gamma production can cause depression," investigators note.

"It has been suggested that immune dysregulation in MS may cause depression, and the increased incidence of depression during disease exacerbation is consistent with this argument.

"Thus the present findings might better be interpreted as supporting the notion that the relationship between immune dysregulation and depression in MS is dynamic and reciprocal."

Archives of Neurology, 2001; 58: 1081-1086. "Treatment of Depression Is Associated With Suppression of Nonspecific and Antigen-Specific T H 1 Responses in Multiple Sclerosis"