Immune parameters in patients with depression versus healthy controls during an open-label, placebo-controlled, randomized trial of reboxetine and celecoxib

Introduction: There is increasing evidence for the involvement of an immune process in the pathophysiology of major depression (MD). Previous studies could demonstrate elevated levels of proinflammatory cytokines as well as elevated PGE₂ levels. Celecoxib is a COX–2 inhibitor, leading to a reduced production of PGE₂. We conducted a randomized and placebo-controlled trial of celecoxib as add-on therapy in patients with MD treated with reboxetine.

Method: Forty patients with MD and 20 healthy controls participated in the study. The patients were treated with reboxetine and celecoxib or placebo. Immune parameters were measured from serum.

Results: Depressed patients showed significantly elevated MIF (p<0,001) and reduced TGF-b (p=0,007) concentrations. There was no difference in sCD14-concentration compared with healthy controls and no difference between the placebo- and the verum-group and no change over the period of the study.

Conclusions: Celecoxib as add-on strategy in the treatment of depressed patients resulted in a significant reduction of MADRS-score. Celecoxib seems to have no influence on MIF, TGF-b or sCD14 concentrations. We also found no differences in sCD14 concentrations between depressed patients and healthy controls. But the significantly elevated levels of MIF and reduced levels of TGF-b of depressed patients may reflect a pathogenetic feature of altered immune state in MD. These parameters may stand as trait markers for MD, rather than state markers.