Last Updated: 2001-07-27 11:07:33 EDT (Reuters Health)
מתוך מדיקונטקסט
By Karla Gale
WESTPORT, CT (Reuters Health) – Treatment of major depressive disorder in patients with relapsing-remitting multiple sclerosis (MS) is accompanied by a reduction in interferon-gamma production, investigators from the University of California in San Francisco report. They therefore suggest that effective treatment of depression may also modify the MS disease process in these patients.
Dr. David C. Mohr, now with the Veterans Affairs Medical Center in San Francisco, and colleagues treated 14 depressed MS patients using either psychotherapy or sertraline for 16 weeks. The nonspecific OKT3-stimulated interferon-gamma and recombinant human myelin oligodendrocyte glycoprotein-stimulated interferon-gamma were measured in peripheral blood mononuclear cells at baseline, week 8 and week 16.
Beck Depression Inventory scores and production of both types of interferon-gamma declined significantly during treatment (p < 0.03 for all three parameters), the researchers report in the Archives of Neurology for July. They infer that the relationship between immune dysregulation and depression in patients with MS is dynamic and reciprocal.
The investigators suggest that "amelioration of depression could be an important factor for down-regulating autoaggressive T cells and therefore may be an important component in the management of patients with MS."
"We already know that there is some relationship between stress and disease activity," Dr. Mohr told Reuters Health. He noted that patients reporting excess stress have demonstrated new brain lesions on MRI 2 months later.
"What we would like to do next is to use behavior models to change patients' ability to cope with their disease, then see if that has an impact on immune function, the occurrence of new brain lesions, and disease progression and exacerbation," Dr. Mohr said.
"We have to be very careful because, on one hand, maybe there are tools to give patients more control over their disease. On the other hand, I would hate to see patients use this information to criticize themselves more," he added, or to make patients think that they are not handling depression or stress well enough.
Dr. Mohr concluded, "A very cautious approach to these types of data are warranted, not only for scientific reasons, but also in the interest of the well-being of these patients."
Arch Neurol 2001;58:1081-1086.
-Westport Newsroom 203 319 2700
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