Abstract
The soluble form of the urokinase receptor, suPAR, has been suggested as a novel biomarker of low-grade inflammation. Activation of the immune system has been proposed to contribute to the development of depression and suicidal behavior. In order to identify depressed and suicidal individuals who could benefit from an anti-inflammatory treatment, a reliable biomarker of low-grade inflammation is vital. This study evaluates plasma suPAR levels as a biomarker of low-grade inflammation in patients with major depressive disorder and in patients who recently attempted suicide. The plasma suPAR and an established biomarker, C reactive protein (CRP) of suicide attempters (n = 54), depressed patients (n = 19) and healthy controls (n = 19) was analyzed with enzyme-linked immunosorbent assays. The biomarker attributes of sensitivity and sensibility were evaluated using ROC curve analysis. Both the depressed patients and suicide attempters had increased plasma suPAR. The levels of suPAR discriminated better between controls and suicide attempters than did CRP. In the future, plasma suPAR might be a superior prognosticator regarding outcome of treatment applying conventional antidepressants in conjunction with anti-inflammatory drugs.
Highlights
Major depressive disorder (MDD) is characterized by low mood, anhedonia and reduced energy [1]
There were no significant differences in C reactive protein (CRP) levels between healthy controls and depressed patients (ANCOVA, NS), Fig 1B
There was a trend of higher levels of CRP in suicide attempters (p = 0.037) but it was below the alpha-level of significance after corrections for multiple comparisons
Summary
Major depressive disorder (MDD) is characterized by low mood, anhedonia and reduced energy [1]. It can cause long-term disability and is a source of significant public health costs [2, 3]. It is a disorder associated with a high mortality rate since suicide ends the life of about 4% of patients with MDD [4]. Neurotransmitter reuptake inhibitors lead to remission only in about 30–45% of patients [6, 7], other factors than brain monoamines might be important in the pathogenesis of depression.
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