Major Depressive Disorder (MDD) is a psychiatric illness that commonly displays a deficit of serotonergic neurotransmission in the central nervous system. MDD patients also show alterations in alterations in cortisol and cytokines levels. Those patients are treated with selective serotonin reuptake inhibitors (SSRIs). The aim of this study was to assess the efficacy of the combined treatment with SSRIs plus an immunomodulator -dialyzable leukocyte extract (DLE) - in restoring the balance of both the serotoninergic system and the endocrinoimmune parameters. A total of 34 patients diagnosed with MDD received anti-depressant treatment with SSRIs plus DLE. As control 31 patients received only SSRIs. Proinflammatory cytokines (Th1) IL-1β, IL-2, IFN-γ, anti-inflammatory cytokines (Th2) IL-13, IL-10, and 24-h urine cortisol were determined at weeks (W) 0, 5, 20, 36 and 52 of treatment. The maximum reduction in cortisol levels in SSRIs group was only 30% (W52). By contrast, the treatment with SSRIs plus DLE decreased 53% the cortisol levels from W20. Reduced cortisol in patients treated with SSRI plus DLE correlated with reductions in the concentration of Th2-cytokine and increases in Th1-cytokines at the end of the study. These results suggest that the immune-stimulating action of DLE, in association with the effects of SSRIs, allowed the immune system to balance the ratio of Th1/Th2 cytokines associated and decreased levels of cortisol.
- Copyright © 2013 by The American Association of Immunologists, Inc.