1. This paper reviews recent findings on cellular and humoral immunity and inflammatory markers in depression. 2. It is shown that major depression may be accompanied by systemic immune activation or an inflammatory response with involvement of phagocytic (monocytes, neutrophils) cells, T cell activation, B cell proliferation, an "acute" phase response with increased plasma levels of positive and decreased levels of negative acute phase proteins, higher autoantibody (antinuclear, antiphospholipid) titers, increased prostaglandin secretion, disorders in exopeptidase enzymes, such as dipeptidyl peptidase IV, and increased production of interleukin (IL)-1 beta and IL-6 by peripheral blood mononuclear cells. 3. It is hypothesized that increased monocytic production of interleukins (Il-1 beta and Il-6) in severe depression may constitute key phenomena underlying the various aspects of the immune and "acute" phase response, while contributing to hypothalamic-pituitary-adrenal-axis hyperactivity, disorders in serotonin metabolism, and to the vegetative symptoms (i.e. the sickness behavior) of severe depression.

Evidence for an immune response in major depression: a review and hypothesis

Increased plasma concentrations of interleukin-6, soluble interleukin-6, soluble interleukin-2 and transferrin receptor in major depression

A systematic, quantitative review of blood autoantibodies in schizophrenia

Increased prevalence of antibrain antibodies in the sera from schizophrenic patients.

The levels of IgM, IgG and IgA were measured in the serum of 337 psychiatric inpatients (92 patients with bipolar depression, 150 patients with unipolar depression and 95 schizophrenics) and compared to 150 healthy subjects. A significantly higher level of IgM was found in all psychiatric groups compared with the controls, and IgM levels were more elevated in female patients than in male patients for the bipolar and unipolar groups. There were no differences for the other immunoglobulins (IgG, IgA) among the groups studied. In 51 of the patients (17 bipolar, 34 unipolar), other measurements were performed (Greactive protein, antinuclear antibodies, lymphocyte antibodies, thyroid antibodies, complement and the third and fourth factors of complement). The unipolar group showed a significant rise of C-reactive protein values and the presence of antinuclear antibodies. Interestingly all patients with antinuclear antibodies were females. No difference was found between psychiatric patients and controls in lymphocyte antibodies, thyroid antibodies and values of complement.

Immunoglobulins, autoantibodies and other serum protein fractions in psychiatric disorders

In a double-blind test to determine whether the antinuclear factor (ANF) was present in patients with psychiatric disorders, a significantly greater number of positive ANF results was found in patients whose conditions were characterized by depression.

Hans Von Brauchitsch

Papers

Antinuclear Factor in Psychiatric Disorders