Correlation between sICAM-1 and depressive symptoms during adjuvant treatment of melanoma with interferon-α

Abstract

Interferon-α (IFN-α) treatment is frequently complicated by symptoms of depression. The mechanism by which peripherally administered IFN-α enters and modulates the central nervous system remains unclear. The cell adhesion molecule ICAM-1 is involved in the regulation of blood–brain barrier (BBB) permeability. ICAM-1 expression was shown to increase during IFN-α treatment and recently the expression of ICAM-1 on vascular endothelial cells in the brain was found to be correlated with the development of depression. We therefore hypothesized that soluble ICAM-1 may be involved in the development of IFN-α associated depression. In a prospective study, serum levels of soluble ICAM-1 (double sandwich ELISA test) and symptoms of depression (SDS) were measured in 48 patients with malignant melanoma before and during adjuvant IFN-α treatment. Both, depression scores and the serum levels of sICAM-1 significantly increased after three months of IFN-α treatment compared to baseline levels ( p<.001). Patients who developed depression (SDS-index scores ⩾ 50) after three months of treatment had higher sICAM-1 levels compared to non-depressed patients. Furthermore, sICAM-1 levels were positively correlated with SDS values ( r=.367, p=.018). Our data provides evidence for an association between the induction of sICAM-1 and the development of symptoms of depression during IFN-α treatment, possibly by enhancing BBB-permeability.