Major depressive disorder and immunity to varicella-zoster virus in the elderly.

TitleMajor depressive disorder and immunity to varicella-zoster virus in the elderly.
Publication TypeJournal Article
Year of Publication2011
AuthorsIrwin, MR, Levin MJ, Carrillo C, Olmstead R, Lucko A, Lang N, Caulfield MJ, Weinberg A, Chan ISF, Clair J, Smith JG, Marchese RD, Williams HM, Beck DJ, McCook PT, Johnson G, Oxman MN
JournalBrain, behavior, and immunity
Date Published2011 May
KeywordsAged, Aged, 80 and over, Aging, Analysis of Variance, Antibodies, Viral, Antidepressive Agents, Case-Control Studies, Cohort Studies, Cross-Sectional Studies, Depressive Disorder, Major, Female, Herpes Zoster, Herpesvirus 3, Human, Humans, Immunity, Cellular, Male, Matched-Pair Analysis, Middle Aged, Reference Values, Risk Factors

Major depressive disorder has been associated with activation of inflammatory processes as well as with reductions in innate, adaptive and non-specific immune responses. The objective of this study was to evaluate the association between major depression and a disease-relevant immunologic response, namely varicella-zoster virus (VZV)-specific immunity, in elderly adults. A cross-sectional cohort study was conducted in 104 elderly community dwelling adults ≥ 60years of age who were enrolled in the depression substudy of the shingles prevention study, a double blind, placebo-controlled vaccine efficacy trial. Fifty-two subjects had a current major depressive disorder, and 52 age- and sex-matched controls had no history of depression or any mental illness. VZV-specific cell-mediated immunity (VZV-CMI) was measured by VZV responder cell frequency (VZV-RCF) and interferon-γ enzyme-linked immunospot (ELISPOT) assays, and antibody to VZV was measured by an enzyme-linked immunosorbent assay against affinity-purified VZV glycoproteins (gpELISA). VZV-CMI, measured by VZV-RCF, was significantly lower in the depressed group than in the controls (p<0.001), and VZV-RCF was inversely correlated with the severity of depressive symptoms in the depressed patients. In addition, an age-related reduction in VZV-RCF was observed in the depressed patients, but not in the controls. Furthermore, there was a trend for depressive symptom severity to be associated with lower ELISPOT counts. Finally, VZV-RCF was higher in depressed patients treated with antidepressant medications as compared to untreated depressed patients. Since lower levels of VZV-RCF appear to explain the increased risk and severity of herpes zoster observed in older adults, these findings suggest that, in addition to increasing age, depression may increase the risk and severity of herpes zoster.

Alternate JournalBrain Behav. Immun.