OBJECTIVE
To evaluate the proinflammatory activity of monocytes (PAM) in depressed patients with schizophrenia by counting the proinflammatory monocyte number and to identify possible correlations between PAM and clinical indicators.
MATERIAL AND METHODS
Sixty-eight women with depressive states in schizophrenia and 23 mentally and somatically healthy age- and sex-matched people were examined. The clinical condition of the patients was assessed by the total PANSS (PANSS_tot) and HDRS (HDRS_tot) scores. PAM was determined in the peripheral blood of patients and healthy controls by counting the number of large monocytes with a diameter of 12.5 to 15 microns on a cell counter and analyzer using the positive magnetic separation method to isolate a pure population of CD14 monocytes.
RESULTS
Before treatment, the level of PAM significantly exceeded the corresponding value in controls (p<0.001) in half of the patients; after treatment, the level of PAM decreased to control values (p<0.001). Linear regression revealed in a subgroup of patients with an initially low PAM level a positive correlation between its value and HDRS tot (r=0.5, p<0.05) before treatment, that is, a low PAM level before treatment was accompanied by low-severity depressive disorders. The analysis of PAM level in the subgroups of patients responding and not responding to treatment revealed a decrease in the PAM value after treatment in the responding patients assessed by PANSS_tot (p<0.05) and in the responding patients assessed by HDRS_tot (p=0.06). Similar patterns were not detected in the subgroups of nonresponders.
CONCLUSION
The correlations between the PAM level and the severity of depressive and other psychopathological disorders in patients with depressive states in schizophrenia may indicate the involvement of immune inflammation in the pathogenesis of this disease. The positive relationship between the initially low PAM level and the mild severity of depressive disorders can be used as a prognostic sign of patients’ response to treatment.
