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Inflammation and clinical response to treatment in depression: A meta-analysis

Research output: Contribution to journalArticle

Original languageEnglish
Pages (from-to)1532–1543
Number of pages12
JournalEuropean neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
Volume25
Issue number10
Early online date20 Jun 2015
DOIs
StatePublished - 1 Oct 2015

King's Authors

Abstract

The depressive state has been characterised as one of elevated inflammation, which holds promise for better understanding treatment-resistance in affective disorders as well as for future developments in treatment stratification. Aiming to investigate alterations in the inflammatory profiles of individuals with depression as putative biomarkers for clinical response, we conducted a meta-analyses examining data from 35 studies that investigated inflammation before and after treatment in depressed patients together with a measure of clinical response. There were sufficient data to analyse IL-6, TNFα and CRP. Levels of IL-6 decreased with antidepressant treatment regardless of outcome, whereas persistently elevated TNFα was associated with prospectively determined treatment resistance. Treatment non-responders tended to have higher baseline inflammation, using a composite measure of inflammatory markers. Our findings suggest that elevated levels of inflammation are contributory to treatment resistance. Combining inflammatory biomarkers might prove a useful tool to improve diagnosis and detection of treatment refractoriness, and targeting persistent inflammation in treatment-resistant depression may offer a potential target for the development of novel intervention strategies.

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