A Potential Shift From Adaptive Immune Activity to Nonspecific Inflammatory Activation Associated With Higher Depression Symptoms in Chronic Heart Failure Patients

Redwine, Laura S.; Wirtz, Petra H.; Hong, Suzi; Pandzic, Ines; Cammarata, Stephanie; Tafur, Joseph; Carter, Steven M.; Greenberg, Barry; Mills, Paul J.

doi:10.1016/j.cardfail.2009.01.011

« Previous Next »Journal of Cardiac Failure
Volume 15, Issue 7 , Pages 607-615, September 2009

A Potential Shift From Adaptive Immune Activity to Nonspecific Inflammatory Activation Associated With Higher Depression Symptoms in Chronic Heart Failure Patients

Laura S. Redwine, PhD
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
- Department of Medicine, University of California, San Diego, La Jolla, CA
- Reprint requests: Dr. Laura S. Redwine, University of California, San Diego, Departments of Psychiatry and Medicine, La Jolla, CA 92161. Tel: (858) 552-8585 x5359.
Petra H. Wirtz, PhD
- Department of Clinical Psychology and Psychotherapy, Psychological Institute, University of Zurich, Zurich, Switzerland
Suzi Hong, PhD
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
Ines Pandzic, BS
- Department of Medicine, University of California, San Diego, La Jolla, CA
Stephanie Cammarata, BS
- Department of Medicine, University of California, San Diego, La Jolla, CA
Joseph Tafur, MD
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
Steven M. Carter, BS
- Department of Medicine, University of California, San Diego, La Jolla, CA
Barry Greenberg, MD
- Department of Medicine, University of California, San Diego, La Jolla, CA
Paul J. Mills, PhD
- Department of Psychiatry, University of California, San Diego, La Jolla, CA

Received 14 October 2008; received in revised form 21 January 2009; accepted 26 January 2009. published online 16 March 2009.

Abstract

Background

Chronic heart failure (CHF) patients with elevated depression symptoms are at greater risk of morbidity and mortality. The mechanisms linking symptoms of depression with disease progression in CHF are unclear. However, research studies have found evidence of alterations in immune activity associated with depression symptoms that may influence heart function. The present study sought to determine the relationship between depression symptoms and chemotaxis of peripheral blood mononuclear cells (PBMCs) in CHF patients, both at rest and in response to moderate exercise.

Methods and Results

Sixty-five patients diagnosed with CHF (mean age, 59.8 ± 14.5 years) and 45 non-CHF control subjects (mean age, 52.1 ± 11.6) completed the Beck Depression Inventory (BDI) before undergoing a moderate 20-minute bicycle exercise task. Chemotaxis of PBMCs was examined in vitro to a bacterial peptide f-met leu phe (fMLP) and a physiologic chemokine, stromal cell derived factor-1 (SDF-1) immediately before and after exercise. CHF patients had reduced chemotaxis to SDF-1 (P = .025) compared with non-CHF subjects. Higher BDI scores were associated with reduced baseline chemotaxis to SDF-1 in both CHF and non-CHF subjects (P = .027). In contrast, higher BDI scores were associated with increased chemotaxis to fMLP (P = .049) and SDF-1 (P = .018) in response to exercise in the CHF patients.

Conclusion

The present study suggests a shift in immune cell mobility in CHF patients with greater depression symptom severity, with reduced chemotaxis to a physiologically specific chemokine at rest but increased chemotaxis to both nonspecific and specific chemical attractants in response to physical activity. This could have implications for cardiac repair and remodeling in CHF patients and therefore may affect disease progression.

Key Words: Immune, dysregulation, heart failure, depression