Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Respiratory Research
Published in: Respiratory Research 1/2013

Open Access 01-12-2013 | Research

Systemic inflammation, depression and obstructive pulmonary function: a population-based study

Authors: Yanxia Lu, Lei Feng, Liang Feng, Ma Shwe Nyunt, Keng Bee Yap, Tze Pin Ng

Published in: Respiratory Research | Issue 1/2013

Login to get access

Abstract

Background

Levels of Interleukin-6 (IL-6) and C-creative protein (CRP) indicating systemic inflammation are known to be elevated in chronic diseases including chronic obstructive pulmonary disease (COPD) and depression. Comorbid depression is common in patients with COPD, but no studies have investigated whether proinflammatory cytokines mediate the association between pulmonary function and depressive symptoms in healthy individuals with no known history of obstructive pulmonary diseases.

Methods

In a population-based sample (n = 2077) of individuals aged 55 and above with no known history of obstructive pulmonary disease in the Singapore Longitudinal Ageing Study (SLAS), we analyzed the relationships between IL-6 and CRP, depressive symptoms (GDS-15 ≥5) and obstructive pulmonary function (FEV1% predicted and FEV1/FVC% predicted).

Results

High serum levels of IL-6 and CRP were associated with greater prevalence of depressive symptoms (p < 0.05). High IL-6, high CRP and depressive symptoms were independently associated with decreased FEV1% predicted and FEV1/FVC% predicted after adjusting for smoking status, BMI and number of chronic inflammatory diseases. Increasing grades of combination of inflammatory markers and/or depressive symptoms was associated with progressive increases in pulmonary obstruction. In hierarchical models, the significant association of depressive symptoms with pulmonary obstruction was reduced by the presence of IL-6 and CRP.

Conclusions

This study found for the first time an association of depressive symptoms and pulmonary function in older adults which appeared to be partly mediated by proinflammatory cytokines. Further studies should be conducted to investigate proinflammatory immune markers and depressive symptoms as potential phenotypic indicators for chronic obstructive airway disorders in older adults.
Appendix
Available only for authorised users
Literature
1.
Corsonello A, Antonelli Incalzi R, Pistelli R, Pedone C, Bustacchini S, Lattanzio F: Comorbidities of chronic obstructive pulmonary disease. Curr Opin Pulm Med. 2011, 17 (Suppl 1): S21-S28.PubMedCrossRef
2.
Gan WQ, Man SF, Senthilselvan A, Sin DD: Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis. Thorax. 2004, 59: 574-580. 10.1136/thx.2003.019588.PubMedPubMedCentralCrossRef
3.
Gompertz S, O'Brien C, Bayley DL, Hill SL, Stockley RA: Changes in bronchial inflammation during acute exacerbations of chronic bronchitis. Eur Respir J. 2001, 17: 1112-1119. 10.1183/09031936.01.99114901.PubMedCrossRef
4.
Chang SS, Vaz Fragoso CA, Van Ness PH, Fried LP, Tinetti ME: Association between combined interleukin-6 and C-reactive protein levels and pulmonary function in older women: results from the Women's Health and Aging Studies I and II. J Am Geriatr Soc. 2011, 59: 113-119. 10.1111/j.1532-5415.2010.03203.x.PubMedPubMedCentralCrossRef
5.
Mannino DM, Ford ES, Redd SC: Obstructive and restrictive lung disease and markers of inflammation: data from the Third National Health and Nutrition Examination. Am J Med. 2003, 114: 758-762. 10.1016/S0002-9343(03)00185-2.PubMedCrossRef
6.
Schols AM, Buurman WA, Staal van den Brekel AJ, Dentener MA, Wouters EF: Evidence for a relation between metabolic derangements and increased levels of inflammatory mediators in a subgroup of patients with chronic obstructive pulmonary disease. Thorax. 1996, 51: 819-824. 10.1136/thx.51.8.819.PubMedPubMedCentralCrossRef
7.
Hurst JR, Donaldson GC, Perera WR, Wilkinson TMA, Bilello JA, Hagan GW, Vessey RS, Wedzicha JA: Use of plasma biomarkers at exacerbation of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2006, 174: 867-874. 10.1164/rccm.200604-506OC.PubMedCrossRef
8.
van Ede L, Yzermans CJ, Brouwer HJ: Prevalence of depression in patients with chronic obstructive pulmonary disease: a systematic review. Thorax. 1999, 54: 688-692. 10.1136/thx.54.8.688.PubMedPubMedCentralCrossRef
9.
Lindqvist D, Janelidze S, Hagell P, Erhardt S, Samuelsson M, Minthon L, Hansson O, Bjorkqvist M, Traskman-Bendz L, Brundin L: Interleukin-6 is elevated in the cerebrospinal fluid of suicide attempters and related to symptom severity. Biol Psychiatry. 2009, 66: 287-292. 10.1016/j.biopsych.2009.01.030.PubMedCrossRef
10.
Howren MB, Lamkin DM, Suls J: Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med. 2009, 71: 171-186. 10.1097/PSY.0b013e3181907c1b.PubMedCrossRef
11.
Hiles SA, Baker AL, de Malmanche T, Attia J: Interleukin-6, C-reactive protein and interleukin-10 after antidepressant treatment in people with depression: a meta-analysis. Psychol Med. 2012, 42 (10): 2015-2026. 10.1017/S0033291712000128.PubMedCrossRef
12.
Niti M, Ng TP, Kua EH, Ho RC, Tan CH: Depression and chronic medical illnesses in Asian older adults: the role of subjective health and functional status. Int J Geriatr Psychiatry. 2007, 22: 1087-1094. 10.1002/gps.1789.PubMedCrossRef
13.
Nyunt MS, Fones C, Niti M, Ng TP: Criterion-based validity and reliability of the Geriatric Depression Screening Scale (GDS-15) in a large validation sample of community-living Asian older adults. Aging Ment Health. 2009, 13: 376-382. 10.1080/13607860902861027.PubMedCrossRef
14.
Standardization of Spirometry, 1994 Update. American Thoracic Society. Am J Respir Crit Care Med. 1995, 152: 1107-1136.
15.
Stone AA: Selected methodological concepts: Mediation and moderation, individual differences, aggregation strategies, and variability of replicates. In Stress and disease processes, Perspectives in behavioral medicine. Edited by Schneiderman N, McCabe P, Baum A. Hillsdale, NJ, England: Lawrence Erlbaum Associates, Inc; 1992:55–71.
16.
Ng TP, Niti M, Fones C, Yap KB, Tan WC: Co-morbid association of depression and COPD: a population-based study. Respir Med. 2009, 103: 895-901. 10.1016/j.rmed.2008.12.010.PubMedCrossRef
17.
Opolski M, Wilson I: Asthma and depression: a pragmatic review of the literature and recommendations for future research. Clin Pract Epidemiol Ment Health. 2005, 1: 18-10.1186/1745-0179-1-18.PubMedPubMedCentralCrossRef
18.
Ng TP, Chiam PC, Kua EH: Mental disorders and asthma in the elderly: a population-based study. Int J Geriatr Psychiatry. 2007, 22: 668-674. 10.1002/gps.1728.PubMedCrossRef
19.
Goodwin RD, Chuang S, Simuro N, Davies M, Pine DS: Association between lung function and mental health problems among adults in the United States: Findings from the First National Health and Nutrition Examination Survey. Am J Epidemiol. 2007, 165: 383-388.PubMedCrossRef
20.
Sluzewska A, Sobieska M, Rybakowski JK: Changes in acute-phase proteins during lithium potentiation of antidepressants in refractory depression. Neuropsychobiology. 1997, 35: 123-127. 10.1159/000119332.PubMedCrossRef
21.
Kubera M, Kenis G, Bosmans E, Zieba A, Dudek D, Nowak G, Maes M: Plasma levels of interleukin-6, interleukin-10, and interleukin-1 receptor antagonist in depression: comparison between the acute state and after remission. Pol J Pharmacol. 2000, 52: 237-241.PubMed
22.
Garrod R, Marshall J, Barley E, Fredericks S, Hagan G: The relationship between inflammatory markers and disability in chronic obstructive pulmonary disease (COPD). Prim Care Respir J. 2007, 16: 236-240. 10.3132/pcrj.2007.00047.PubMedCrossRef
23.
de Torres JP, Cordoba-Lanus E, Lopez-Aguilar C, Muros de Fuentes M, Montejo de Garcini A, Aguirre-Jaime A, Celli BR, Casanova C: C-reactive protein levels and clinically important predictive outcomes in stable COPD patients. Eur Respir J. 2006, 27: 902-907.PubMed
24.
Yanbaeva DG, Dentener MA, Spruit MA, Houwing-Duistermaat JJ, Kotz D, Passos VL, Wouters EF: IL6 and CRP haplotypes are associated with COPD risk and systemic inflammation: a case-control study. BMC Med Genet. 2009, 10: 23-PubMedPubMedCentralCrossRef
25.
Yoshida M, Sakuma J, Hayashi S, Abe K, Saito I, Harada S, Sakatani M, Yamamoto S, Matsumoto N, Kaneda Y, Kishimoto T: A Histologically Distinctive Interstitial Pneumonia Induced by Overexpression of the Interleukin-6, Transforming Growth-Factor-Beta-1, or Platelet-Derived Growth-Factor-B Gene. Proc Natl Acad Sci U S A. 1995, 92: 9570-9574. 10.1073/pnas.92.21.9570.PubMedPubMedCentralCrossRef
26.
Hierholzer C, Kalff JC, Omert L, Tsukada K, Loeffert JE, Watkins SC, Billiar TR, Tweardy DJ: Interleukin-6 production in hemorrhagic shock is accompanied by neutrophil recruitment and lung injury. Am J Physiol Lung Cell Mol Physiol. 1998, 275: L611-L621.
27.
Park CS, Chung SW, Ki SY, Lim GI, Uh ST, Kim YH, Choi DI, Park JS, Lee DW, Kitaichi M: Increased levels of interleukin-6 are associated with lymphocytosis in bronchoalveolar lavage fluids of idiopathic nonspecific interstitial pneumonia. Am J Respir Crit Care Med. 2000, 162: 1162-1168. 10.1164/ajrccm.162.3.9906007.PubMedCrossRef
28.
Hogg JC, Chu F, Utokaparch S, Woods R, Elliott WM, Buzatu L, Cherniack RM, Rogers RM, Sciurba FC, Coxson HO, Pare PD: The nature of small-airway obstruction in chronic obstructive pulmonary disease. N Engl J Med. 2004, 350: 2645-2653. 10.1056/NEJMoa032158.PubMedCrossRef
29.
Kuhn C, Homer RJ, Zhu Z, Ward N, Flavell RA, Geba GP, Elias JA: Airway hyperresponsiveness and airway obstruction in transgenic mice. Morphologic correlates in mice overexpressing interleukin (IL)-11 and IL-6 in the lung. Am J Respir Cell Mol Biol. 2000, 22: 289-295. 10.1165/ajrcmb.22.3.3690.PubMedCrossRef
30.
Janssen SPM, Gayan-Ramirez G, Van Den Bergh A, Herijgers P, Maes K, Verbeken E, Decramer M: Interleukin-6 causes myocardial failure and skeletal muscle atrophy in rats. Circulation. 2005, 111: 996-1005. 10.1161/01.CIR.0000156469.96135.0D.PubMedCrossRef
31.
Johnston RA, Schwartzman IN, Flynt L, Shore SA: Role of interleukin-6 in murine airway responses to ozone. Am J Physiol Lung Cell Mol Physiol. 2005, 288: L390-L397.PubMedCrossRef
32.
Penninx BW, Kritchevsky SB, Yaffe K, Newman AB, Simonsick EM, Rubin S, Ferrucci L, Harris T, Pahor M: Inflammatory markers and depressed mood in older persons: results from the Health, Aging and Body Composition study. Biol Psychiatry. 2003, 54: 566-572. 10.1016/S0006-3223(02)01811-5.PubMedCrossRef
33.
Kiecolt-Glaser JK, Glaser R: Depression and immune function: central pathways to morbidity and mortality. J Psychosom Res. 2002, 53: 873-876. 10.1016/S0022-3999(02)00309-4.PubMedCrossRef
34.
Konsman JP, Parnet P, Dantzer R: Cytokine-induced sickness behaviour: mechanisms and implications. Trends Neurosci. 2002, 25: 154-159. 10.1016/S0166-2236(00)02088-9.PubMedCrossRef
35.
Lanquillon S, Krieg JC, Bening-Abu-Shach U, Vedder H: Cytokine production and treatment response in major depressive disorder. Neuropsychopharmacology. 2000, 22: 370-379. 10.1016/S0893-133X(99)00134-7.PubMedCrossRef
36.
Basterzi AD, Aydemir C, Kisa C, Aksaray S, Tuzer V, Yazici K, Goka E: IL-6 levels decrease with SSRI treatment in patients with major depression. Hum Psychopharmacol. 2005, 20: 473-476. 10.1002/hup.717.PubMedCrossRef
37.
38.
Broekhuizen R, Wouters EF, Creutzberg EC, Schols AM: Raised CRP levels mark metabolic and functional impairment in advanced COPD. Thorax. 2006, 61: 17-22.PubMedPubMedCentralCrossRef
39.
Man SF, Connett JE, Anthonisen NR, Wise RA, Tashkin DP, Sin DD: C-reactive protein and mortality in mild to moderate chronic obstructive pulmonary disease. Thorax. 2006, 61: 849-853. 10.1136/thx.2006.059808.PubMedPubMedCentralCrossRef
40.
Shaaban R, Kony S, Driss F, Leynaert B, Soussan D, Pin I, Neukirch F, Zureik M: Change in C-reactive protein levels and FEV1 decline: a longitudinal population-based study. Respir Med. 2006, 100: 2112-2120. 10.1016/j.rmed.2006.03.027.PubMedCrossRef
41.
Salvi S, Blomberg A, Rudell B, Kelly F, Sandstrom T, Holgate ST, Frew A: Acute inflammatory responses in the airways and peripheral blood after short-term exposure to diesel exhaust in healthy human volunteers. Am J Respir Crit Care Med. 1999, 159: 702-709. 10.1164/ajrccm.159.3.9709083.PubMedCrossRef
42.
Maes M, Yirmiya R, Noraberg J, Brene S, Hibbeln J, Perini G, Kubera M, Bob P, Lerer B, Maj M: The inflammatory & neurodegenerative (I&ND) hypothesis of depression: leads for future research and new drug developments in depression. Metab Brain Dis. 2009, 24: 27-53. 10.1007/s11011-008-9118-1.PubMedCrossRef
43.
Manton KG: A longitudinal study of functional change and mortality in the United States. J Gerontol. 1988, 43: S153-S161. 10.1093/geronj/43.5.S153.PubMedCrossRef
44.
Yong V, Saito Y, Chan A: Gender differences in health and health expectancies of older adults in Singapore: an examination of diseases, impairments, and functional disabilities. J Cross Cult Gerontol. 2011, 26: 189-203. 10.1007/s10823-011-9143-0.PubMedCrossRef
45.
Singapore DoS: Complete life tables 2006–2008 for Singapore resident population. 2009, Singapore
Metadata
Title
Systemic inflammation, depression and obstructive pulmonary function: a population-based study
Authors
Yanxia Lu
Lei Feng
Liang Feng
Ma Shwe Nyunt
Keng Bee Yap
Tze Pin Ng
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Respiratory Research / Issue 1/2013
Electronic ISSN: 1465-993X
DOI
https://doi.org/10.1186/1465-9921-14-53

Other articles of this Issue 1/2013

Respiratory Research 1/2013 Go to the issue

Review

Transposable elements and their potential role in complex lung disorder

Research

Hypoxia-induced mitogenic factor (HIMF/FIZZ1/RELMα) in chronic hypoxia- and antigen-mediated pulmonary vascular remodeling

Research

Mesenchymal stem cells promote alveolar epithelial cell wound repair in vitro through distinct migratory and paracrine mechanisms

Research

Ex vivo expanded human cord blood-derived hematopoietic progenitor cells induce lung growth and alveolarization in injured newborn lungs

Research

Low-dose CT measurements of airway dimensions and emphysema associated with airflow limitation in heavy smokers: a cross sectional study

Research

Physical activity level and its clinical correlates in chronic obstructive pulmonary disease: a cross-sectional study
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits