Abstract

Major Depressive Disorder (MDD) is a leading cause of disability worldwide, creating a high medical and socioeconomic burden. There is a growing interest in the biological underpinnings of depression, which are reflected by altered levels of biological markers. Among others, enhanced inflammation has been reported in MDD, as reflected by increased concentrations of inflammatory markers—C-reactive protein, interleukin-6, tumor necrosis factor-α and soluble interleukin-2 receptor. Oxidative and nitrosative stress also plays a role in the pathophysiology of MDD. Notably, increased levels of lipid peroxidation markers are characteristic of MDD. Dysregulation of the stress axis, along with increased cortisol levels, have also been reported in MDD. Alterations in growth factors, with a significant decrease in brain-derived neurotrophic factor and an increase in fibroblast growth factor-2 and insulin-like growth factor-1 concentrations have also been found in MDD. Finally, kynurenine metabolites, increased glutamate and decreased total cholesterol also hold promise as reliable biomarkers for MDD. Research in the field of MDD biomarkers is hindered by insufficient understanding of MDD etiopathogenesis, substantial heterogeneity of the disorder, common co-morbidities and low specificity of biomarkers. The construction of biomarker panels and their evaluation with use of new technologies may have the potential to overcome the above mentioned obstacles.

Highlights

  • Depression, or Major Depressive Disorder (MDD) is the most prevalent psychiatric disorder worldwide and a leading cause of disease burden [1]

  • Elevated concentrations of corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), antidiuretic hormone (ADH) and decreased dehydroepiandrosterone (DHEA) levels have been reported in MDD

  • By way of illustration, elevated cortisol in saliva after waking can serve as a biomarker for depression in adolescents [223] and an elevated cortisol concentration in hair could be a new measure of chronic stress exposure

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Summary

Introduction

Depression, or Major Depressive Disorder (MDD) is the most prevalent psychiatric disorder worldwide and a leading cause of disease burden [1]. It is mainly characterized by depressed mood, anhedonia, sleep and appetite disturbances, loss of interest or pleasure in activities once enjoyed and feelings of guilt or worthlessness. Currently available evidence is insufficient to allow for regarding of them as biomarkers sensu stricto. Alterations in their concentrations may provide relevant information concerning the pathophysiology of depression and be a starting point for future, larger biomarker studies

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