EVIDENCE FOR AN IMMUNE RESPONSE IN MAJOR DEPRESSION: A REVIEW AND HYPOTHESIS MICHAEL MAES Department of Psychiatry, University Hospitals of Cleveland, Cleveland, OHIO, USA (Final form, January 1994) Contents 1. 2. 3. 3.1. 3.2. 3.3. 3.4. 3.5. 3.6. 3.7. 4. 4.1. 4.2. 4.3. 4.4. 4.5. 5. 6. Abstract Introduction Major Depression and Immunity Aims and Results of Present Studies Leukocytes, T Cells and Major Depression Interleukins and Major Depression B cells, Autoimmunity and Major Depression Acute Phase response and Major Depression Peptidases and Major Depression Sensitivity and Specificity of Immune Variables Conclusions Immune Activation: Inferences and Hypotheses Interleukins and Immune Response Immune Activation and the Acute Phase Response Immune Activation and Hypothalamic-Pituitary-Adrenal Axis. Immune Activation and Serotonin Immune Activation and In zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIH Vitro Immune Tests Hypotheses Conclusions References I1 12 12 14 14 IS Ih Ih 17 IX 1x 20 20 20 21 23 24 25 25 27 Abstract Maes Michael: Evidence for an Immune Response in Major Depression. A Review and Hypotheses. Prog. Neuro-Psychopharmacol. & Biol. Psychiat. 1995, 19( 1): 11-M. 1. This paper reviews recent findings on cellular and humoral immunity and inflammatoq markers in depression. 2. It is shown that major depression may be accompanied by systemic immune activation or an inflammatory response with involvement of phagocytic (monocytes, neutrophils) cells, T cell activation, B cell proliferation, an “acute” phase response with increased plasma levels zyxwvuts 11