Table of Contents Author Guidelines Submit a Manuscript
Clinical and Developmental Immunology
Volume 2013, Article ID 267871, 11 pages
http://dx.doi.org/10.1155/2013/267871
Clinical Study

Effect of Selective Serotonin Reuptake Inhibitors and Immunomodulator on Cytokines Levels: An Alternative Therapy for Patients with Major Depressive Disorder

1Department of Psychoimmunology, National Institute of Psychiatry “Ramón de la Fuente”, Calzada México-Xochimilco 101, Col. San Lorenzo Huipulco, Tlalpan, 14370 Mexico City, DF, Mexico
2Universidad Autónoma Metropolitana. Avenida San Rafael Atlixco No. 186, Col. Vicentina, Iztapalapa, 09340 Mexico City, DF, Mexico
3National Institute of Psychiatry “Ramón de la Fuente”, Calzada México-Xochimilco 101, Col. San Lorenzo Huipulco, Tlalpan, 14370 Mexico City, DF, Mexico
4Department of Immunology, National School of Biological Sciences (ENCB), National Polytechnic Institute (IPN), 11340 Mexico City, DF, Mexico
5Departamento de Inmunología, Instituto Nacional de Cardiología, 14080 Mexico City, DF, Mexico

Received 27 July 2013; Accepted 27 September 2013

Academic Editor: Rogelio Hernández-Pando

Copyright © 2013 María Eugenia Hernandez et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Major depressive disorder (MDD) is a psychiatric illness that presents as a deficit of serotonergic neurotransmission in the central nervous system. MDD patients also experience alterations in cortisol and cytokines levels. Treatment with selective serotonin reuptake inhibitors (SSRIs) is the first-line antidepressant regimen for MDD. The aim of this study was to determine the effect of a combination of SSRIs and an immunomodulator—human dialyzable leukocyte extract (hDLE)—on cortisol and cytokines levels. Patients received SSRIs or SSRIs plus hDLE. The proinflammatory cytokines IL-1β, IL-2, and IFN-γ; anti-inflammatory cytokines IL-13 and IL-10; and 24-h urine cortisol were measured at weeks (W) 0, 5, 20, 36, and 52 of treatment. The reduction in cortisol levels in the SSRI-treated group was 30% until W52, in contrast, the combined treatment induced a 54% decrease at W36. The decline in cortisol in patients who were treated with SSRI plus hDLE correlated with reduction of anti-inflammatory cytokines and increases levels of proinflammatory cytokines at the study conclusion. These results suggest that the immune-stimulating activity of hDLE, in combination with SSRIs, restored the pro- and anti-inflammatory cytokine balance and cortisol levels in depressed patients versus those who were given SSRIs alone.