ALTERATIONS IN IRON-METABOLISM AND THE ERYTHRON IN MAJOR DEPRESSION -FURTHER EVIDENCE FOR A CHRONIC INFLAMMATORY PROCESS

There is now some evidence that major depression is accompanied by bio chemical and immune changes pointing to the presence of a chronic infl ammatory response. The latter condition is reportedly characterized by changes in iron (Fe) metabolism and the erythron, such as decreased s erum Fe and transferrin (Tf) and increased serum ferritin, lower numbe r of red blood cells (RBC), lower hematocrit (Htc) and hemoglobin (Hb) . The aim of the present study was to examine Fe metabolism and the er ythron in 38 major depressed subjects versus 15 normal volunteers, as well as the effects of antidepressant treatments on these variables. M ajor depressed subjects had significantly lower serum Fe and Tf, a low er number of RBC, lower Htc and Hb, and a significantly increased numb er of reticulocytes than normal controls. Serum ferritin was significa ntly higher in major depressed patients with melancholia than in those with simple major depression and normal controls, Mean corpuscular vo lume (MCV), MC Hb (MCH), MC Hb concentration (MCHC) and RBC distributi on width (RDW) were not significantly different between major depresse d subjects and normal controls. Treatment with antidepressants during 5 weeks had no significant effect on the alterations in number of RBC and reticulocytes, Htc, Hb, Fe and Tf. There were significant relation ships between the above Fe and erythron variables and established immu ne-inflammatory markers of major depression, e.g., lowered serum album in and zinc and the increased electrophoretically-separated alpha(1)-g lobulin fraction. The results suggest that the disorders in Fe metabol ism and the erythron during major depression may be induced by the imm une-inflammatory response in that illness.