Sertraline with desvenlafaxine and sertraline with mirtazapine as treatment initiation in MDD patients with moderate to severe depression and effect on inflammatory markers.

BACKGROUND: This study evaluated the effect of sertraline with desvenlafaxine and sertraline with mirtazapine on HAM-D score and inflammatory markers (IL-6 and TNF-α levels) in major depressive disorder. METHODS: Patients (18-60 years) with MDD diagnosed by DSM-V criteria and HAM-D score 18 or more were included (n = 60). Group A patients (n = 30) received sertraline 50 mg/day and desvenlafaxine 50 mg/day. Group B patients (n = 30) received sertraline 50 mg/day and mirtazapine 30 mg/day. All patients were followed up for 8 weeks for the evaluation of clinical efficacy, safety, serum IL-6, and TNF-α levels. RESULTS: Our study showed a comparatively similar and statistically significant (p < 0.05) reduction in HAM-D score in both groups in the 4th and 8th week of the treatment. Both drug combinations significantly (p < 0.05) decreased serum IL-6 and TNF-α after 8 weeks of treatment. CONCLUSION: The present study suggests that the combination therapy (as treatment initiation) with sertraline and desvenlafaxine, and sertraline with mirtazapine is effective and well tolerated in MDD patients with moderate to severe depression, and their therapeutic efficacy is accompanied by decreased inflammatory markers (serum IL-6 and TNF-α).

Recent evidence indicates that combination therapy of antidepressant drugs started as treatment initiation produces superior treatment outcomes in patients of MDD with moderate to severe depression.MDD is associated with increased inflammatory markers.Combination therapy of sertraline with desvenlafaxine and sertraline with mirtazapine as treatment initiation is effective and well tolerated in MDD patients.The therapeutic efficacy of sertraline with desvenlafaxine and sertraline with mirtazapine is associated with a significant decrease in serum levels of IL-6 and TNF-α.

Bupropion monotherapy alters neurotrophic and inflammatory markers in patients of major depressive disorder.

BACKGROUND: Emerging hypotheses in the pathophysiology of major depressive disorder (MDD) indicate the role of neurotrophic factors and inflammation. This study assessed the association between therapeutic response of bupropion and serum brain-derived neurotrophic factor (BDNF) and tumour necrosis factor-α (TNF-α) levels in patients with MDD. METHODS: Thirty patients (aged 18 to 60 years) with MDD diagnosed by DSM-5 criteria, with Hamilton Depression Rating scale (HAM-D) score ≥ 20 were included in the study. Patients were given bupropion sustained release (SR) in the doses of 150 mg once daily. All patients were followed up for 12 weeks. RESULTS: HAM-D score at the start of the treatment was 25.57 ± 1.85 which significantly reduced to 10.8 ± 4.24 at 12 weeks of treatment. The serum BDNF level increased significantly (p < 0.05) from 2.42 ± 0.19 ng/ml to 2.97 ± 0.10 ng/ml and the levels of serum TNF-α reduced significantly (p < 0.05) from 4.45 ± 0.95 pg/ml to 2.11 ± 0.84 pg/ml at 12 weeks of treatment, in responders to treatment. CONCLUSION: The results of our study suggest that bupropion SR monotherapy is effective and well tolerated in MDD patients with moderate to severe depression, and its therapeutic efficacy is accompanied by an increase in serum BDNF levels and a decrease in serum TNF-α levels.

Inflammatory-mediated pathway in association with organochlorine pesticides levels in the etiology of idiopathic preterm birth.

Elevated inflammation is a known risk factor in the pathogenesis of PTB. Despite intensive research, the etiology of idiopathic PTB is still unknown. The present study was designed to explore associations of blood concentrations of organochlorine pesticides (OCPs) with inflammatory/antioxidant gene expression, and cytokines and prostaglandin levels in PTB cases. Significantly high levels of α, ß-hexachlorocyclohexane (α, ß-HCH), dichlorodiphenyldichloroethane (o'p'-DDD), dichlorodiphenyldichloroethylene (p'p'-DDE), increased expression of cyclooxygenase-2 (COX-2), and decreased expression of manganese superoxide dismutase (Mn-SOD) and catalase (CAT) genes were seen in PTB cases. Also, increased protein levels of interleukin-6 (IL-6) and decreased protein levels of interleukin-4 (IL-4) and prostaglandin F2α (PGF2α) were found in maternal blood of PTB cases as compared to term controls. Elevated levels of ß-HCH along with high expression of COX-2 gene or low expression of Mn-SOD or CAT genes were associated with the decrease in the period of gestation (POG).

Occurrence of organochlorine pesticide residues in eggs, chicken and meat in Jordan.

Organochlorine pesticide (OCP) residues in 519 samples; comprising eggs, chicken and meat (lamb and beef), collected from Jordan were determined. All samples were analyzed for their residual contents of aldrin, dichlorodiphenyltrichloroethane and metabolites (DDTs), dieldrin, endosulfan isomers, endrin, hexachlorocyclohexane isomers (HCHs), heptachlor, heptachlor epoxide and hexachlorobenzene (HCB). The samples were Soxhlet extracted for 8h in 250mL petroleum ether. The cleanup of the samples was performed by Florisil column chromatography and analysis was done on a gas chromatography equipped with an electron capture detector (GC-ECD). The results indicated that 28% (38/134), 20% (23/115) and 49% (131/270) of the examined eggs, chicken and meat samples, respectively, were contaminated with OCP residues. HCHs and DDTs are the most prominently noticed compounds, as they were detected at a high incidence. On the other hand, heptachlor, heptachlor epoxide, HCB, aldrin and endrin compounds were only present in less than 7% of the analyzed samples. These residues are present despite complete ban on the use of OCPs for agricultural purposes in Jordan. No residues of op'-DDD, op'-DDT, dieldrin, alpha-endosulfan and beta-endosulfan were detected.

Organochlorine pesticide residues in dairy products in Jordan.

The use of aldrin, dieldrin, endrin, heptachlor and hexachlorobenzene (HCB) has been banned in Jordan officially in 1981, and of dichlorodiphenyltrichloroethane (DDT) in 1995. However, residues of such compounds can still be found in the environment and in foodstuffs. Dairy products are an important exposure route for organochlorine pesticides (OCPs) to humans. For this reason, the presence of OCP residues in 233 dairy product samples; comprising milk, butter, cheese, labaneh and yoghurt collected from Jordan was determined. All samples were analyzed for their residual contents of aldrin, DDT and metabolites (DDTs), dieldrin, endosulfan isomers, endrin, hexachlorocyclohexane isomers (HCHs), heptachlor and HCB. Levels of these compounds were determined by gas chromatography with electron capture detector (GC-ECD). The results indicated that 9% (21/233), 8.5% (20/233), 6% (14/233) and 2.1% (5/233) of the examined samples were contaminated with beta-HCH, pp'-DDE, alpha-HCH and gamma-HCH, respectively. Heptachlor and alpha-endosulfan were only present in less than 2% of the analyzed samples. None of the samples revealed the presence of aldrin, op'-DDD, pp'-DDD, op'-DDE, op'-DDT, pp'-DDT, dieldrin, beta-endosulfan, endrin and HCB at their detection limits. The order for the contamination in the analyzed dairy products was labaneh>cheese>yoghurt>butter>milk. This study has provided the preliminary information on the concentration of OCPs in dairy products for the first time in Jordan. The results will help in a scientific assessment of the implications of pesticide residues with regards to human risks in Jordan.

Lindane-induced immunological alterations in human poisoning cases.

OBJECTIVES: Evaluation of immunological alterations in the blood of human lindane poisoning cases. DESIGN AND METHODS: Serum IgG, IgM, IgA, IgE, IL-2, IL-4, TNF-alpha, and IFN-gamma levels were measured using immunoassay in 20 human cases of lindane poisoning. The presence of lindane in blood was confirmed by HPLC. RESULTS: Serum IL-2, IL-4, and TNF-alpha levels were significantly raised with decrease in IFN-gamma levels in the lindane-exposed cases. Immunoglobulin levels were not altered. CONCLUSIONS: The results suggest that lindane exposure at chronically high levels affects cytokine levels in humans and indicates the severity of immunotoxicity.