Cited by 188Tryptophan and brain disordersStress Responses and CortisolTreatment of Major Depression

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Peripheral Blood Cell–Stratified Subgroups of Inflamed Depression

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Lynall, Mary-Ellen, Turner, Lorinda, Bhatti, Junaid, Cavanagh, Jonathan, de Boer, Peter, Mondelli, Valeria, Jones, Declan, Drevets, Wayne C., Cowen, Philip, Harrison, Neil A., Pariante, Carmine M., Pointon, Linda, Clatworthy, Menna R., Bullmore, Edward·2020·Biological Psychiatry

DOI 10.1016/j.biopsych.2019.11.017

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Abstract

Background Depression has been associated with increased inflammatory proteins, but changes in circulating immune cells are less well defined.Methods We used multiparametric flow cytometry to count 14 subsets of peripheral blood cells in 206 depression cases and 77 age- and sex-matched controls (N = 283). We used univariate and multivariate analyses to investigate the immunophenotypes associated with depression and depression severity.Results Depression cases, compared with controls, had significantly increased immune cell counts, especially neutrophils, CD4+ T cells, and monocytes, and increased inflammatory proteins (C-reactive protein and interleukin-6). Within-group analysis of cases demonstrated significant associations between the severity of depressive symptoms and increased myeloid and CD4+ T-cell counts. Depression cases were partitioned into 2 subgroups by forced binary clustering of cell counts: the inflamed depression subgroup (n = 81 out of 206; 39%) had increased monocyte, CD4+, and neutrophil counts; increased C-reactive protein and interleukin-6; and more severe depression than the uninflamed majority of cases. Relaxing the presumption of a binary classification, data-driven analysis identified 4 subgroups of depression cases, 2 of which (n = 38 and n = 100; 67% collectively) were associated with increased inflammatory proteins and more severe depression but differed in terms of myeloid and lymphoid cell counts. Results were robust to potentially confounding effects of age, sex, body mass index, recent infection, and tobacco use.Conclusions Peripheral immune cell counts were used to distinguish inflamed and uninflamed subgroups of depression and to indicate that there may be mechanistically distinct subgroups of inflamed depression.

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Self-citation

Authors: Lynall, M.-E., Turner, L., Bhatti, J., Cavanagh, J., de Boer, P., Mondelli, V., Jones, D., Drevets, W. C., Cowen, P., Harrison, N. A., Pariante, C. M., Pointon, L., Clatworthy, M. R., & Bullmore, E.
Affiliations: University of Cambridge (GB)
Queen Elizabeth University Hospital (GB)
King's College London (GB)
Janssen (United Kingdom) (GB)
Janssen Research & Development (United States) (US)
Warneford Hospital (GB)
Cardiff University (GB)
Corresponding author: Lynall, Mary-Ellen
ORCID: Lynall, Mary-Ellen
Turner, Lorinda
Cavanagh, Jonathan
Mondelli, Valeria
Jones, Declan
Drevets, Wayne C.
Cowen, Philip
Harrison, Neil A.
Pariante, Carmine M.
Pointon, Linda
Clatworthy, Menna R.
Bullmore, Edward
Venue: Biological Psychiatry
Publisher: Elsevier BV
Published: 2020-07
Volume: 88
Issue: 2
Pages: 185-196
ISSN: 0006-3223 (ISSN-L)
DOI: 10.1016/j.biopsych.2019.11.017
OpenAlex: W2991010196
Cited by: 187
References: 44
Citations by year: 2026: 22 · 2025: 38 · 2024: 40 · 2023: 9 · 2022: 42 · 2021: 27 · 2020: 9
FWCI: 6.42
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Biological Psychiatry (publishedVersion)
PubMed (publishedVersion)
ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
Apollo (University of Cambridge) (submittedVersion, cc-by-nc-nd)
Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
Research Portal (King's College London) (submittedVersion)
Apollo
Funders: Addenbrooke's Charitable Trust, Cambridge University Hospitals
Arthritis Research UK
Medical Research Council
National Institute for Health Research
Wellcome Trust
Topics: Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Keywords: depression, peripheral blood cells, immune cell subsets, inflammation, depression severity, neutrophils, CD4+ T cells, monocytes, C-reactive protein, interleukin-6, myeloid cells, lymphoid cells, immunophenotype
MeSH terms: Depression, Flow Cytometry, Monocytes, Immunophenotyping, Lymphocyte Count

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Peripheral Blood Cell–Stratified Subgroups of Inflamed Depression

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