T-cell immune parameters and depression in patients with Crohn's disease

The causes of Crohn's disease (CD) are still considered to be unknown. It is likely that an immune defect leads to an increase in T helper 1 (Th1) cytokine responses, which may then contribute to the characteristic morphologic changes. Increased values in distinct immune activation parameters connected with a Th1 immune response have also been found in patients who are depressed. Because various clinical observations have asserted that a depressive disposition may have some connection with the development of CD, we examined whether a relationship exists between T-cell activation parameters and depressive personality characteristics in patients with CD.

Seventy-one patients (62% women; age, 38 +/- 13 years) with CD (23 with CD Activity Index [CDAI] >150 and 48 with CDAI < or =150) were included in this study. Sixty patients were re-examined after 4.4 +/- 1.8 months. The T cell parameters CD2, CD3, CD26, CD28, and CD95 and the activity of dipeptidyl peptidase IV (DPP IV) in serum were examined in the peripheral blood. The patient's subjective health status was assessed by means of a standardized psychometric instrument (Short-form Inflammatory Bowel Disease Questionnaire [SIBDQ]). The presence of various characteristics indicative of a depressed mood was also assessed (Center of Epidemiological Studies-Depression Scale, Berliner Stimmungsfragebogen), as well as indicators of a personality disposed to depression (Giessentest) and a depressive illness coping strategy (Freiburger Krankheitsverarbeitungs-Fragebogen), all using the above-mentioned standardized instruments.

The immune parameters connected with the activation of Th1 (CD25+, CD25+/CD26+) are increased in patients, depending on the stage of illness. In addition, DPP IV activity was significantly lower in patients with an active disease, as was their subjective health status (SIBDQ). A connection with an indicator of mental depression could not be found.

The observed changes in immune parameters support the idea that morphologic changes could be connected with an increased Th1 response and that DPP IV activity could play an immunomodulatory role. A relationship between the measured immune parameters and individual characteristics of depression could not be found.