Treatment for depression ranges from various forms of therapy to treatments and prescribed antidepressants. A new study revealed that genetic markers of inflammation and stress can help determine which patients with depression will effectively respond to antidepressants.
King's College London collaborated with several universities from the UK, the University of Milan in Italy, and Janssen Parmaceutica by Johnson & Johnson on a study published in Traditional Psychiatry. 130 patients with major depressive disorder were compared to 40 healthy adults as a part of the Biomarkers in Depression (BIODEP) Study.
The BIODEP study has been an on-going study for more than 2.5 years to discover 'the role of inflammatory processes in depression.' Five universities and four pharmaceutical companies in the UK have collaborated to determine the biomarkers for depression.
The team looked into gene expression, or chemical signals of protein production, that can distinguish which patients have treatment-resistant depression (TRD). Almost 50% of patients with depression were treatment-resistant. The results can help doctors develop a personalized treatment that does not involve antidepressant medication but use anti-inflammatory drugs instead.
Treatment-Resistant Depression
Patients taking antidepressants often find the right medication and appropriate doses as a result of trial and error. For the 30% of depressed patients that resist antidepressants, prescribing anti-inflammation drugs might work.
Antidepressants aim to achieve a chemical balance that affects mood and behavior. Also, a study shows that antidepressants and weight gain are both affected in terms of its metabolism and hunger levels. The most common types raise levels of serotonin, the happy chemical which is associated with happiness and well-being. However, most of these drugs come with side effects.
Dr. Annamaria Cattaneo said that 'there is overwhelming evidence' of depression being associated with inflammation while much is to be discovered of how this occurs within the body. In the UK, about 20% of the population has depression with 30% of depressed patients resistant to antidepressants.
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Inflammation
The team observed that the patients with TRD had significantly stronger inflammation and stress levels compared to those taking antidepressants. Previously, depression had been associated with levels of C-reactive protein (CRP), which indicates inflammation levels in the body.
CRP levels in the blood increase when there is inflammation in the body. CRP tests are normally done for the indication of infection or a chronic inflammatory disease such as arthritis, lupus, or heart disease.
The high levels of CRP were accompanied by 16 genes that the team measured, including several genes that are related to the expression of inflammation. Some of the genes had never been measured in any other study.
Another part of the study involved stress indicators, where all patients were found to have low amounts of glucocorticoid receptors, hormones that fight inflammation, and work with the immune system. Low levels of the receptors result in the body's weakened ability to process cortisol and other stress hormones, increasing the risk of severe depression.
Professor Carmine Pariante said that their results support the link between depression, inflammation, and stress biomarkers. This can 'especially impact the future of personalized psychiatry,' he said.
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