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Treating depression in MS may help physical health

NEW YORK, Jul 27 (Reuters Health) - Treatment of major depression in patients with relapsing-remitting multiple sclerosis (MS) is accompanied by a reduction in the immune system substance interferon-gamma, investigators from the University of California, San Francisco have found. They say this suggests treatment of depression may also modify the MS disease process.

Dr. David C. Mohr, now with the Veterans Affairs Medical Center in San Francisco, and colleagues treated 14 MS patients using either psychotherapy or the antidepressant sertraline for 16 weeks. At the beginning, midpoint and end of the study, the researchers measured the patients' blood levels of interferon-gamma, a naturally occurring chemical linked to the worsening of MS.

Mohr and colleagues found that both the patients' depression symptoms and interferon-gamma production declined significantly during treatment. The findings are published in the July issue of the Archives of Neurology.

MS is a disease of the central nervous system marked by symptoms such as weakness, loss of coordination and vision problems. In its relapsing-remitting form, the symptoms come in bouts interspersed with periods of remission. MS is also an autoimmune disease in which the immune system wrongly attacks the protective myelin sheath around nerve fibers.

Based on these new findings, Mohr's team speculates that in MS patients, immune dysregulation and depression help feed each other.

The investigators suggest that "amelioration of depression could be an important factor for down-regulating [dysfunctional] T cells and therefore may be an important component in the management of patients with MS." The immune system's T cells are believed to play an important role in MS.

"We already know that there is some relationship between stress and disease activity," Mohr told Reuters Health.

"What we would like to do next," he said, "is to use behavior models to change patients' ability to cope with their disease, then see if that has an impact on immune function...and disease progression and exacerbation."

However, Mohr added, "a very cautious approach to these types of data are warranted, not only for scientific reasons, but also in the interest of the well-being of these patients."

SOURCE: Archives of Neurology 2001;58:1081-1086.

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