Pharmacopsychiatry 2009; 42(5): 182-188
DOI: 10.1055/s-0029-1202263
Original Paper

© Georg Thieme Verlag KG Stuttgart · New York

Imbalance between Pro- and Anti-inflammatory Cytokines, and between Th1 and Th2 Cytokines in Depressed Patients: The Effect of Electroacupuncture or Fluoxetine Treatment

C. Song1 , U. Halbreich2 , C. Han3 , B. E. Leonard4 , H. Luo3
  • 1Department of Biomedical Sciences, University of Prince Edward Island, Canada
  • 2Biobehavior Program, State University of New York at Buffalo, USA
  • 3Institute of Mental Health, Peking University, China
  • 4Department of Psychiatry and Psychotherapy, Laborsektion Psychoneuroimmunologie, Ludwig Maximilian Universität, München, Germany
Further Information

Publication History

received 25.08.2008 revised 17.12.2008

accepted 23.12.2008

Publication Date:
01 September 2009 (online)

Abstract

Background: An increase in inflammatory response and an imbalance between T-helper (Th) 1 and 2 functions have been implicated in major depression. The aims of the present study were to 1) study the relationship between pro- and anti-inflammatory cytokines and between Th1 and Th2 produced cytokines in depressed patients and 2) evaluate and compare the effect of treatments with electroacupuncture (EA) and fluoxetine on these cytokines.

Methods: 95 outpatients with major depressive disorder were treated for 6 weeks with EA, fluoxetine or placebo. Hamilton Depression Rating Scale (HDRS) and Clinical Global Impression (CGI) were used to assess severity and therapeutic effects. 30 volunteers served as controls. Serum cytokine concentrations were measured by ELISA.

Results: Increased proinflammatory cytokine interleukin (IL)-1β and decreased anti-inflammatory cytokine IL-10 were found in the depressed patients. By contract, Th1 produced proinflammatory cytokines, tumor necrosis factor (TNF)-α and interferon (IFN)-γ were decreased, and Th2 produced cytokine IL-4 was significantly increased in depressed patients. The ratio of IFN/IL-4 was also increased. Both acupuncture and fluoxetine treatments, but not the placebo, reduced IL-1β concentrations in responders. However, only acupuncture attenuated TNF-α concentration and INF-γ/IL-4 ratio towards the control level.

Discussion: These results suggest that an imbalance between the pro- and anti-inflammatory cytokines (IL-1 and IL-10), and between Th1 and Th2 cytokines (INF-γ or TNF-α and IL-4) occurred in untreated depressed patients. Both EA and fluoxetine had an anti-inflammatory effect by reducing IL-1β. EA treatment also restored the balance between Th1 and Th2 systems by increasing TNF-α and decreasing IL-4.

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Correspondence

C. SongMD, PhD 

Neuroimmunology Research Lab

Department of Biomedical Science, AVC

University of Prince Edward Island

550 University Ave.

Charlottetown

P.E. Canada C1A 4P3

Phone: 902/566/79 77

Fax: 902/566/74 68

Email: cai.song@nrc.gc.ca

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