Role of TNF and Hs CRP as novel biomarkers in etiopathogenesis of depression: A case-control study

Abstract

Depression is a psychiatric disorder characterized by depressed mood, loss of interest in activities and loss of energy that lasts for two weeks or more. Depression affects individual emotional and psychological well-being with low self-esteem and ultimately resulted in social isolation. Nearly half of all cases of depression remain undetected for years or inadequately controlled. TNF-α has a vital role in inflammation, cell proliferation, differentiation, apoptosis, innate and adaptive immunity and have pathological role in several diseases. Early assessment of TNF-α and hs-CRP levels in depression patients could modify the disease progression and limit co-morbidities associated with it. Therefore, we assessed the level of TNF-α and hs-CRP in our study and correlated it with the disease severity.: to study is to estimate TNF-α and hs-CRP levels in depressed patients and evaluate the relationship between the serum level of TNF- α and hs-CRP in the etiopathogenesis of depression. This study was conducted at a tertiary level post graduate teaching institute of central India. 50 newly diagnosed drug naive cases of depression of age group 18-50 years, attending Psychiatry OPD. And 50 apparently healthy controls matched for same age and sex were taken. The subjects were enrolled for the study after taking ethics committee approval and obtaining written consent. The data collected was expressed as mean ± SD and analysed by using SPSS version 20. P-value of < 0.05 was accepted as statistically significant. The mean value of serum TNF-α among control group (11.209 ± 6.058 Pg/ml) which was lower as compared to case group (33.816 ± 21.581 Pg/ml). The difference among the two groups was found to be statistically significant as p value is less than 0.001. The mean Serum hs-CRP concentration was found to be higher in case group (7.524 ± 1.842 mg/l) as compare to control group (3.720 ± 1.238 mg/l). The difference among the two groups was found to be statistically significant as p value is <0.05. The difference among the three groups was found to be statistically significant as p value is less than 0.001. We observed a strong association between depression and increased serum TNF-α, with raised hs-CRP. There are several researches potentiating the vital role of TNF- α and hs-CRPin depression. Large scale prospective studies are needed to establish the cause effect relationship and role of inflammatory cytokines in depression and to find newer treatment modalities like TNF-α blockers that might be helpful for consideration of new therapeutic approach Further studies are essential to detect the association. Nevertheless we found that depression might be responsible for elevated TNF-α and hs-CRP levels. We suggest screening of all the patients of depression for serum TNF-α estimation at initial OPD visit.