BIOCHEMICAL CORRELATES OF IN-VIVO CELL-MEDIATED IMMUNE DYSFUNCTION INPATIENTS WITH DEPRESSION - A PRELIMINARY-REPORT

We have previously demonstrated that at least 50% of patients with mel ancholia have impaired cell-mediated immunity (CMI) as assessed by del ayed-type hypersensitivity (DTH) skin responses to a standardized batt ery of antigens. Hypercortisolaemia and increased circulating catechol amines both occur in patients with severe depressive disorders and eac h has been proposed as a possible mediator of observed immune abnormal ities in patients with mood disorders. As part of a lager study, we co llected 24 h urine samples from 28 patients with major depression and measured concentrations of urinary free cortisol (UFC), the noradrenal ine metabolite dihydroxyphenylglycol (DHPG), adrenaline, and the dopam ine metabolite DOPAC. CMI multitest skin testing revealed a reduced or absent response in 54% of subjects. Those with reduced DTH skin respo nses demonstrated increased urinary adrenaline (P<0.02), with trends t owards increased UFC (P=0.052) and increased DHPG (P=0.06). These diff erences could not be attributed to differences in age or depression se verity. Correlational analyses demonstrated inverse associations betwe en the extent of DTH responsiveness and 24 h levels of urinary adrenal ine and DHPG, with similar trends evident for UFC and DOPAC. These res ults suggest that both circulating catecholamines and cortisol may pla y roles in the reduction of CMI in patients with severe depression.