Risk assessment and predicting outcomes in patients with depressive symptoms: a review of potential role of peripheral blood based biomarkers

Abstract

Depression is one of the major global health challenges and a leading contributor of health related disability and costs. Depression is a heterogeneous disorder and current methods for assessing its severity in clinical practice rely on symptom count, however this approach is unreliable and inconsistent. The clinical evaluation of depressive symptoms is particularly challenging in primary care, where the majority of patients with depression are managed, due to the presence of co-morbidities. Current methods for risk assessment of depression do not accurately predict treatment response or clinical outcomes. Several biological pathways have been implicated in the pathophysiology of depression; however, accurate and predictive biomarkers remain elusive. We conducted a systematic review of the published evidence supporting the use of peripheral biomarkers to predict outcomes in depression, using Medline and Embase. Peripheral biomarkers in depression were found to be statistically significant predictors of mental health outcomes such as treatment response, poor outcome and symptom remission; and physical health outcomes such as increased incidence of cardiovascular events and deaths, and all-cause mortality. However, the available evidence has multiple methodological limitations which must be overcome to make any real clinical progress. Despite extensive research on the relationship of depression with peripheral biomarkers, its translational application in practice remains uncertain. In future, peripheral biomarkers identified with novel techniques and combining multiple biomarkers may have a potential role in depression risk assessment but further research is needed in this area.

Altered serum interleukin-7 and interleukin-10 are associated with drug-free major depressive disorder

“…8 Evidence suggests that factors associated with the inflammatory process, neurotransmission, neurotrophy, neuroendocrine and metabolic systems could be used to recognize the mechanism of disease for individuals suffering from depression. 9 The biological markers for understanding the pathophysiology of MDD are rare, and although there are few risk assessment factors, the findings are largely inconsistent.…”

Biomarkers for Depression: Recent Insights, Current Challenges and Future Prospects

“…19 The evidence to date suggests that markers reflecting the activity of inflammatory, neurotransmitter, neurotrophic, neuroendocrine and metabolic systems may be able to predict mental and physical health outcomes in currently depressed individuals, but there is much inconsistency between findings. 20 In this review, we focus on these five biologic systems.…”

Depression and Inflammatory Periodontal Disease Considerations—An Interdisciplinary Approach

“…Moreover, animal studies have demonstrated that various classes of antidepressants can reduce levels of oxidative stress markers (Eren et al, 2007a , b ; Maes et al, 2011a ; Leonard and Maes, 2012 ), increase several endogenous antioxidants (Maes et al, 2011a ) and also decrease the periodontal disease severity (Branco-de-Almeida et al, 2012 ; Aguiar et al, 2013 ; Galli et al, 2013 ). Captivatingly, these biological processes have been revealed to participate to the aetiology of depression and periodontal disease co-morbidities, as well, and thus may represent a bridge between these pathologies (Maes et al, 2011b ; Bullon et al, 2014 ; Rossetti et al, 2014 ; Jani et al, 2015 ; Kang et al, 2015 ). Changes in health-related behaviors , such as oral hygiene, smoking, diet, alcohol consumption that occurs in depressed patients can also be related to the occurrence of periodontal disease (Kurer et al, 1995 ; D'Alessandro et al, 2014 ; Peltzer and Pengpid, 2014 ; Yuen et al, 2014 ; Alkan et al, 2015 ).…”