nd the hippocampus of depressed people (while BDNF is high in the nucleus accumbens).
There is growing evidence of a link between inflammation of depression. At the 2015 meeting of the Society of Biological Psychiatry, researcher Jeff Meyer summarized past studies on inflammatory markers. These are measurements, for example of certain proteins in the blood, that indicate the presence of inflammation in the body.
Common inflammatory markers that have been linked to depression include IL-6, TNF-alpha, and c-reactive protein. At the meeting, Meyer reviewed the findings on each of these. Twelve studies showed that IL-6 levels are elevated in the blood of patients with depression. Four studies had non-significant results of link between IL-6 and depression, and Meyer found no studies indicating that IL-6 levels were lower in those with depression. Similarly, for TNF-alpha, Meyer found 11 studies linking elevated TNF-alpha with depression, four with non-significant results, and none showing a negative relationship between TNF-alpha and depression. For c-reactive protein, six studies showed that c-reactive protein was elevated in people with depression, six had non-significant results, and none indicated that c-reactive protein was lower in depressed patients.
Most studies that have linked inflammation to depression have done so by measuring inflammatory markers in the blood. It is more difficult to measure inflammation in the brain of living people, but Meyer has taken advantage of new developments in positron emission tomography (PET) scans to measure translocator protein binding, which illustrates when microglia are activated. Microglial activation is a sign of inflammation. Translocator protein binding was elevated by about 30% in the prefrontal cortex, anterior cingulate cortex, and insula in study participants who showed symptoms of a major depressive episode compared to healthy control participants. The implication is that the depressed people with elevated translocator protein binding have more brain inflammation, probably via microglial activation.
The antibiotic minocycline reduces microglial activation. It would be interesting to see if minocycline might have antidepressant effects in people with depression symptoms and elevated translocator protein binding.
Depression and bipolar disorder have been linked to high levels of inflammatory proteins in the blood (namely CRP, IL-1, IL-6, and TNF-alpha), but the relationship between these illnesses and inflammation in the brain has not been well-characterized.
At the 2015 meeting of the Society for Biological Psychiatry, researcher Ghanshyan Pandey discussed findings from autopsy studies of people who died with a diagnosis of unipolar depression or bipolar disorder, and teens who died of suicide. The studies compare data from these ill people with those of controls who are matched for demographic characteristics.
Pandey found that the brains of those who died of unipolar depression and bipolar disorder showed more signs of inflammation compared to the controls. This included elevated levels of the inflammatory proteins IL-1B, IL-6, and TNF-alpha, in addition to elevated levels of the mRNA that leads to their production. Pandey also found that those with depression and bipolar disorder had higher levels of mRNA for the receptors to which TNF-alpha and other inflammatory proteins attach themselves.
Pandey performed similar autopsy studies of teens who died of suicide, the second leading cause of death for this age group, compared to teens who died of other causes. There were more signs of inflammation in the prefrontal cortices of teens who died of suicide. These included mRNA and proteins for IL-1B and TNF-alpha, and IL-6 proteins. In contrast to the ill adults, the teens who died of suicide had lower levels of the receptors for inflammatory proteins than controls. Another type of receptor known as toll-like receptors was higher in the ill teens, particularly the mRNA and proteins TLR3 and TLR4.
George Koob, Director of the National Institute on Alcohol Abuse and Alcoholism