[Immune profiles of patients with juvenile depression: association with clinically high risk of psychosis manifestation].

OBJECTIVES

To study the change of the levels of inflammatory markers in young patients with depression with a clinically high risk of psychosis manifestation (CHR-P) during therapy.

MATERIAL AND

METHODS

The study included 80 adolescent patients (mean age 19.6±2.3 years) with the first depressive episode (F32.1, F32.2, F32.38, F32.8 according to ICD-10), who were divided into two groups: Group 1 with CHR-P (n=58) and Group 2 without CHR-P (n=22). The HDRS-21, SOPS, and SANS scales were used to assess the severity of psychopathological symptoms. Patients received combined pharmacotherapy with antidepressants and antipsychotics. The mean duration of treatment was 1.16±0.2 months. Blood levels of tumor necrosis factor-α, interleukins IL-6, IL-8, IL-10, C-reactive protein (CRP), the activity of leukocyte elastase and α1-proteinase inhibitor, their ratio (leukocyte inhibitory index, LII), as well as the level of autoantibodies to the S100B protein and the myelin basic protein were measured.

RESULTS

Patients with juvenile depression associated with CHR-P had qualitative and quantitative features of the spectrum of inflammatory indicators, both before and after the therapy, different from those in patients without CHR-P. The key differences between the groups were in the levels of TNF-α, IL-6, IL-10, CRP, and autoantibodies to S100B (p<0.05). Despite the improvement in clinical symptoms (p<0.001), the inflammatory response persisted in some patients (both with and without CHR-P) after treatment, indicating an ongoing pathological process in the brain. The most unfavorable in terms of prognosis was an immunotype characterized by a decrease in LII combined with a high level of other inflammatory markers (CRP, IL-6, and autoantibodies to neural tissue proteins). It was detected in 70% of patients with CHR-P and was associated with a longer duration of the depressive episode and the severity of symptoms detected before the start of therapy.

CONCLUSION

The results support using the studied inflammation markers to assess the prognosis of the disease development and the risk of psychosis manifestation in young patients.