Effects of antidepressant treatments on polymorphonuclear elastase levels in patients with depression

Background: We have previously reported that severe depression is associate d with immunological and inflammatory alterations and these alterations may be showed easily by polymorphonuclear elastase (PMNE) measurements. The pu rpose of the present study is to show how PMN elastase levels change before and after antidepressant treatment. Methods: Fifty-five patients with depr ession (40 with major depression [MD], 15 with dysthymic disorder [DD]) wer e included in the study. Blood samples were drawn prior to drug treatment, and 3 months after the treatment. Severity of depression was measured by 24 -item Hamilton depression rating scale (HDRS). Results: There was a positiv e correlation between Delta PMNE levels and Delta HDRS in patients with MD, but not in patients with DD. Twenty-eight patients were given moclobemide, and 27 patients were given imipramine. It was seen that PMN elastase level s were significantly reduced after 3-month antidepressant treatment period only in patients with MD. Conclusion: These findings suggest that PMNE acti vity is a state dependent parameter and improvement of depressive symptoms due to antidepressant treatment may lead to decrement of PMNE levels. Clini cal implication and limitations: PMN elastase measurements may be used as a sensitive biological marker to follow the time-course of the disease activ ity in patients with major depression. (C) 2000 Elsevier Science B.V. All r ights reserved.