Abstract
ObjectiveInterleukin 6 (IL-6) levels are commonly elevated in patients with depression and psychosis and in people who are at risk of developing these disorders. A common, functional variant in the IL6R gene (IL6R Asp358Ala; rs2228145 A > C) is known to dampen down inflammation by impairing IL6R signaling. We have examined the association of Asp358Ala with diagnosis of depression and psychosis, serum IL-6, CRP levels, and a number of risk factors commonly linked with inflammation, depression or psychosis. We predicted that if IL-6 were related to depression/psychosis risk causally, rather than due to confounding, Asp358Ala would be associated with risk of these disorders, serum IL-6, CRP levels, but not with any of the confounders. MethodWe used data from the population-based ALSPAC birth cohort. Serum IL-6 and CRP levels were measured at age 9 years. Psychotic disorder, ICD-10 diagnosis of severe depressive episode, and total depression score were assessed at age 18 years. IL6R Asp358Ala was genotyped using the Illumina HumanHap550 quad genome-wide SNP genotyping platform. Risk factors assessed include sex, body mass index, social class, ethnicity, maternal education, birth weight, gestational age, maternal post-natal depression, childhood psychological and behavioral problems, and total IQ score. ResultsAsp358Ala was associated with decreased risk of severe depression and/or psychosis; adjusted odds ratio for those with CC, compared with AA, genotype was 0.38 (95% CI, 0.15–0.94). The variant was associated with increased serum IL-6 levels (P = 5.5 × 10−22) but decreased serum CRP levels (P = 3.5 × 10−5), consistent with an anti-inflammatory effect downstream of IL-6. Asp358Ala was not associated with total depression score. Asp358Ala was not associated with any of the other risk factors commonly linked with inflammation, depression or psychosis (all P > 0.20). ConclusionsThe findings provide further evidence that the IL-6/IL6R pathways are involved in pathogenesis of severe depression and psychosis, and may be novel therapeutic targets. Previously reported associations between IL-6, depression and psychosis are unlikely to be fully explained by confounding. Based on a small number of cases, findings from the current study need replication in other samples.
Highlights
Experimental, clinical and epidemiological studies indicate that inflammatory cytokines may contribute to pathogenesis of depression and psychosis, of which interleukin 6 (IL-6) is one of the leading candidates
Using data from a population-based birth cohort, we report that a common, functional variant in the IL-6 receptor (IL6R) gene (IL6R Asp358Ala; rs2228145 A > C) that is known to dampen down inflammation is associated with decreased risk of severe depression and/or psychosis
The variant is associated with increased serum IL-6 levels but decreased serum C-Reactive Protein (CRP) levels, which is consistent with an anti-inflammatory effect of the minor 358Ala allele downstream of IL-6 previously reported by others (Ferreira et al, 2013)
Summary
Experimental, clinical and epidemiological studies indicate that inflammatory cytokines may contribute to pathogenesis of depression and psychosis, of which interleukin 6 (IL-6) is one of the leading candidates. Injecting mice with IL-6, which controls serotonin transporter levels and serotonin reuptake (Kong et al, 2015), leads to depression-like behaviour (Sukoff Rizzo et al, 2012). Please cite this article in press as: Khandaker, G.M., et al Association between a functional interleukin 6 receptor genetic variant and risk of depression and psychosis in a population-based birth cohort.
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