Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Symptomatic human immunodeficiency virus (HIV) infection is accompanied by depressed CD4+ T-lymphocyte counts. These cells seem to play a role in the inflammatory processes in Crohn's disease. It has even been speculated that depression of CD4+ T-lymphocytes in HIV infection may cure Crohn's disease. Here we describe a 41-year-old drug-addicted man with a 9-year history of Crohn's disease. HIV infection was diagnosed 8 years ago. At present he has stage-C3 HIV infection. He was admitted because of weight loss and chronic diarrhea with rectal blood and mucus discharge. Crohn's disease was confirmed endoscopically and histologically. Infectious diarrhea known to mimic Crohn's disease in patients with acquired immunodeficiency syndrome (AIDS) was excluded. In summary, we describe a patient with AIDS (CD4 count, 84/microliter) and active Crohn's disease, showing that both illnesses can occur simultaneously.
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PMID:Concomitant active Crohn's disease and the acquired immunodeficiency syndrome. 881 26

Non-compliance with therapy is a significant problem, particularly when the disease process is chronic and therapeutic regimens are employed for prolonged periods. We assessed the prevalence and variables associated with compliance with antiretroviral therapy in patients with human immunodeficiency virus infection, by means of a longitudinal observational study of 46 patients aged 23 to 68 years, with human immunodeficiency virus infection, followed at the Pittsburgh VA Medical Center. Data on demographics, medical status, physical functioning (Karnofsky performance scores), CD4 lymphocyte count, depression (Beck depression inventory), coping (inventory of coping with illness scale scores), and psychological and emotional stress (profile of mood states scale scores), were prospectively assessed on all patients at baseline and every 6 months. Compliance was assessed at 6 and 12 months: patients taking > or = 80% of antiretroviral therapy were considered compliant. Overall, 63% of patients were compliant with antiretroviral therapy. Age, education, employment, religious support, and perceived quality of life did not correlate with compliance. By univariate analysis, lack of prior intravenous drug use was significantly associated with compliance (p = 0.01). Compliant patients had significantly better adaptive coping (p = 0.03), and less depression (p = 0.04). By multivariate analysis, black race was significantly associated with non-compliance independent of intravenous drug use and educational status. History of prior opportunistic infection (which presumably heightens the perceived severity of illness) (p = 0.02), and lesser psychological disturbance scores (p = 0.02) were associated with compliance. Compliance was observed despite the greater number of prescription medications taken by compliant patients (p = 0.04). At 12 months, Karnofsky scores were better in compliant patients (p = 0.02), although mortality was not different. Besides identifying predictors of compliance, our data suggest that symptoms of depression and psychological stress be sought in patients with non-adherence.
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PMID:Determinants of compliance with antiretroviral therapy in patients with human immunodeficiency virus: prospective assessment with implications for enhancing compliance. 882 19

Aging is a physiological process that shares many behavioral, biochemical and neuroendocrine phenomena with the pathophysiological situation of unresolved stress, as well as with a pharmacologically induced syndrome resulting from chronic benzodiazepine (BZ) consumption. Behavioral findings include symptoms such as drowsiness, ataxia, fatigue, confusion, weakness, dizziness, vertigo, syncope, reversible dementia, depression, impairment of intellectual, psychomotor and sexual function, agitation, auditory and visual hallucinations, paranoid ideation, panic, delirium, depersonalization, sleepwalking, aggressivity, orthostatic hypotension, and insomnia. Neuroendocrine findings include: central depletion of noradrenaline (NA), dopamine, adrenaline (AD), and serotonin (5-HT); reduction in the ratio of circulating NA/AD as well as platelet 5-HT and increase of AD, plasma free 5-HT and cortisol. These disturbances together with the increased platelet aggregability observed in the three groups are typical of unresolved-stress situations. Immunological findings include significant reduction of peripheral T lymphocytes (CD3, CD4, CD8) and the CD4/CD8 ratio, CD16 and gamma-delta cells. On the other hand, the three groups (elderly subjects, subjects faced with unresolved stress, and BZ consumers) show increase of the CD57 lymphocyte subset as well as natural killer cytotoxicity. Alterations of several biological markers have also been found, specifically in the oral glucose tolerance test, the intramuscular clonidine test, and the supine/orthostasis/exercise test. From a clinical point of view, the three groups appear to be more susceptible to the appearance and progression of many acute and chronic diseases (infectious and malignant diseases). As a result, chronic consumption of BZs should be avoided in both the elderly and subjects in unresolved-stress situations.
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PMID:Benzodiazepines: tolerability in elderly patients. 884 97

Depression is a serious, common, and treatable condition among HIV-infected persons. We examined the prevalence and predictors of depression and use of mental health services among 475 HIV-infected men without AIDS. Participants were drawn from three sites in San Francisco and Denver that did not provide ongoing medical care or mental health services. Depression was measured using the Center for Epidemiology Studies Depression scale (CES-D). Overall, 176 men (37.1%) were classified as depressed based on having a CES-D score above the standard cut-off of > or = 16. In logistic regression analysis, persons with HIV-related symptoms (OR = 3.4; 95% CI = 2.0.-5.6), low social support (OR = 2.5; 95% CI = 1.6-3.9), who were unemployed (OR = 1.9; 95% CI = 1.1-3.3), and with CD4 count < 200 cells (OR = 1.9; 95% CI = 1.1-3.3), were significantly more likely to be depressed. Only 40.3% of depressed men had seen a mental health clinician in the previous year and only 6.3% were taking an antidepressant. Among depressed men, in logistic regression analysis, men who were unemployed (OR = 2.4; 95% CI = 1.2-4.7) and those with health insurance (OR = 2.2; 95% CI = 1.1-4.5) were more likely to have received these services. Increased evaluation and treatment of HIV-infected persons for depression is needed.
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PMID:Depression and use of mental health services among HIV-infected men. 886 14

A novel immunosuppressant, FTY720, induces a rapid and marked decrease of peripheral lymphocytes, and prolong allograft survival in rats. Its mechanism of action is mediated by apoptotic cell death. In this study, we determined the time-related changes in the numbers of total lymphocytes, and the ratios of lymphocyte subpopulations in peripheral blood and lymphomyeloid organs in rats after the single oral administration of FTY720 (10 mg/kg), comparing with the effects of cyclophosphamide (80 mg/kg, ip). Total number of peripheral lymphocytes decreased significantly 3 h after the administration of the drug, while that of polymorphonuclear cells increased. T-cells were markedly decreased in number and reached a minimum of 2.3% of the control 3 days after the treatment, while B-cells reached 19.7%. T-cells decreased in spleen and liver but there was no notable change in thymus, lymph nodes, and bone marrow. The susceptibility of the cells against the drug was variant based on the type and the source of cells in vitro. Polymorphonuclear cells were the most resistant and lymph node cells the most sensitive to FTY720 after 3 h incubation with different concentration of the drug (1, 10,100 mumol/l). When incubated with 10 mumol/l of FTY720, B-cells were significantly higher in viability than the whole T- or CD4-cells. These results demonstrated that FTY720 induces cell death selectively in mature T-lymphocytes, especially CD4-lymphocytes, in peripheral blood without the depression of bone marrow.
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PMID:Induction of selective cell death targeting on mature T-lymphocytes in rats by a novel immunosuppressant, FTY720. 888 61

Our research group has conducted clinical trials of standard (imipramine, fluoxetine, and sertraline) and alternative antidepressants (dextroamphetamine and testosterone replacement therapy) in the treatment of clinical depression among patients with human immunodeficiency virus (HIV) illness. This report presents secondary analyses of data pooled from these trials with the purpose of comparing the antidepressant efficacy of these various agents. In all trials, a DSM-III-R depressive disorder was the primary criterion for study entry, and each treatment resulted in significant improvement after both 2 and 6 weeks of treatment according to the Hamilton Depression Rating Scale (HDRS). Response rates for standard antidepressants ranged from 70% to 74%, with similar, high response rates found in trials of dextroamphetamine (93%) and testosterone (81%). The response rate of each active drug treatment was superior to that of placebo (33%). Each treatment was well-tolerated in terms of side effects, and there was essentially no effect of any treatment on CD4 cell count. Differences in trial design, entrance criteria, and measurements require that caution be used in interpreting these results; nonetheless, each of the five treatments studied demonstrated strong efficacy and possessed relatively unique benefits, providing health care providers with valuable treatment options in addressing individual needs of patients.
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PMID:A comparative analysis of standard and alternative antidepressants in the treatment of human immunodeficiency virus patients. 893 64

Prospective relations between individual differences in both lateralised neuro-psychophysiological functions and mood ratings with immune status (CD4 and CD8 counts) were examined in asymptomatic HIV-positive men (n = 27) over thirty months. They participated in a controlled study of zidovudine versus placebo (results published elsewhere). Measures included EEG spectra, neuropsychological tests and mood ratings. A model of reciprocal lateralised influences on the immune system was tested whereby patients with left superior to right hemispheric functions were predicted to show a less deleterious outcome than those with the opposite asymmetry pattern. Prospective relations with immune status were found in the EEG with lateralised theta, alpha and beta activity; among cognitive measures with word fluency, semantic processing, and lateralised motor and recognition memory (word/face) processes; with mood ratings including depression, confusion and the total mood score. The nature of the effects supported the laterality predictions. These unique data, showing that neuro-psychophysiological factors in HIV+ but otherwise healthy subjects predict immune competence and compromise present 2-3 years later, warrant replication in a larger cohort.
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PMID:Prospective associations between lateralised brain function and immune status in HIV infection: analysis of EEG, cognition and mood over 30 months. 894 87

Research has suggested that attributions-the perceived causes of events-may affect psychological and physical health and the immune system. The authors hypothesized that attributions reflecting negative beliefs about the self, the future, and control would affect helper T cell (CD4) decline and onset of AIDS in individuals with HIV, either directly or through associations with psychological states such as depression. HIV+ gay men (N = 86) participated in a structured interview from which causal attributions were extracted and coded. Attributing negative events to aspects of the self significantly predicted faster CD4 decline over 18 months following the interview, controlling for potential psychological, behavioral, social, and health mediators such as depression and health behavior. However, attributions did not predict AIDS diagnosis during the study period. The results support the idea that causal attributions related to beliefs about the self may have an influence on the immune system.
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PMID:Causal attributions predict rate of immune decline in HIV-seropositive gay men. 897 30

Many studies have demonstrated depressed mitogenic responses in trauma/burn patients' peripheral blood mononuclear cells (PBMC). However, data attributing the relative contribution of secreted inhibitory factors versus a true T cell dysfunction to these depressed mitogenic responses have been conflicting. We have characterized the T cell dysfunctions in posttrauma mitogen depression by simultaneously assessing patient T cell proliferation in the phytohemagglutinin-stimulated PBMC and in the purified T cell population induced with anti-CD3 + anti-CD4. Patients' samples showed three distinct patterns or progressive phases of T cell responses: (i) normal or elevated T cell proliferation in both the whole PBMC and the isolated T cell population (phase I); (ii) depressed T cell proliferation in the PBMC but normal, or even elevated, proliferation in the isolated T cell population (phase II); and (iii) depressed T cell proliferation in both the PBMC and the isolated T cell population (phase III). Patients whose T cells exhibited only a phase I response experienced no major complications with a positive clinical outcome. Patients whose T cell alterations progressed to phase II experienced infectious episodes and some complications, but all had positive clinical outcomes. In contrast, patients whose T cells progressed to phase III dysfunction had severe clinical complications (multiple organ failure), with a negative clinical outcome (80% mortality). Patients whose T cells had a phase I or phase II response pattern had no true T cell dysfunctions in the absence of monocytes. However, patients whose T cells had a true T cell dysfunction (phase III) response pattern were at high risk for mortality. Thus, a true T cell dysfunction, though occurring in only a minority of trauma patients, is predictive of clinical outcome.
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PMID:Only a subset of trauma patients with depressed mitogen responses have true T cell dysfunctions. 900 45

The relationship between markers of immune function and chronic fatigue syndrome (CFS) is controversial. To examine the relationship directly, 43 subjects with CFS entering a randomized controlled trial of a nonpharmacological treatment for CFS gave samples for immunological analysis before and after treatment. Percentage levels of total CD3+ T cells, CD4 T cells, CD8 T cells, and activated subsets did not differ between CFS subjects and controls. Naive (CD45RA+ RO-) and memory (CD45RA- RO+) T cells did not differ between subjects and controls. Natural killer cells (CD16+/CD56+/CD3-) were significantly increased in CFS patients compared to controls, as was the percentage of CD11b+ CD8 cells. There were no correlations between any immune variable and measures of clinical status, with the exception of a weak correlation between total CD4 T cells and fatigue. There was a positive correlation between memory CD4 and CD8 T cells and depression scores and a negative correlation between naive CD4 T cells and depression. No immune measures changed during the course of the study, and there was no link between clinical improvement as a result of the treatment program and immune status. Immune measures did not predict response or lack of response to treatment. In conclusion, we have been unable to replicate previous findings of immune activation in CFS and unable to find any important associations between clinical status, treatment response, and immunological status.
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PMID:Clinical improvement in chronic fatigue syndrome is not associated with lymphocyte subsets of function or activation. 900 46


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