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Objective: Ceruloplasmin is a serum protein synthesized by hepatocytes and involved in both copper and iron metabolism. It is an acute phase reactant and has antioxidant capacity (1). Deficiency of ceruloplasmin is thought to cause neural cell damage secondary to decreased mitochondrial energy production and increased lipid peroxidation, and iron associated free radicals (2,3). Ceruloplasmin, an antioxidant agent, has previously been investigated in some psychiatric disorders like schizophrenia and obsessive compulsive disorder (4). Studies about ceruloplasmin in depression are relatively scarce (5). In this prospective study, we aimed to determine the serum ceruloplasmin levels of depressive patients before and after treatment, to compare them those of healthy control subjects and to assess any possible association of ceruloplasmin levels to treatment response.
Methods: Among the admissions to the Psychiatry Outpatients Clinic of Gaziantep University Medical Faculty Hospital 19 (8 males, 11 females) patients who were diagnosed with major depressive disorder according to the DSM-IV criteria and 40 (17 ales, 23 females) healthy control subjects have been included in the study. The patients received naturalistic antidepressant treatment during the 8 weeks period after the diagnosis. The serum ceruloplasmin levels and the Hamilton Depression Rating Scale (HAM-D) scores of the patients were measured before and after the 8 week period of antidepressant treatment. Blood collection for ceruloplasmin measurement was done only once for the healthy control subjects. The measurement of ceruloplasmin levels was conducted according to the standard procedures.
Results: The ceruloplasmin levels of patients both before and after antidepressant treatment were significantly higher than those of control subjects (t=7.569, p<0.001 and t=6.764, p<0.001, respectively). Despite clinical improvement, ceruloplasmin levels did not show any statistically significant change after antidepressant treatment in the patient group (t= -1.163, p=0.260).
Conclusion: Compared to healthy control subjects, serum ceruloplasmin levels seemed to be higher in patients with depression. There was no significant change in its level with antidepressant treatment. High levels of serum ceruloplasmin, an antioxidant agent, may be a consequence of some mechanisms that try to balance increased oxidative stress which was previously shown in patients with depression. The persistance of high levels of serum ceruloplasmin after antidepressant treatment may show some ongoing possible underlying pathophysiological mechanisms in depression despite its acute treatment.
References:
1. Floris G, Medda R, Padiglia A, Musci G. The physiopathological significance of ceruloplasmin. A possible therapeutic approach. Biochem Pharmocol 2000; 60: 1735-1741
2. Yoshida K, Kaneko K, Miyajima H, Tokuda T, Nakamura A, Kato M, Ikeda S. Increased lipid peroxidation in the brains of aceruloplasminemia patients. J Neurol Sci 2000; 175: 91–95
3. Vassiliev V, Harris ZL, Zatta P. Ceruloplasmin in neurodegenerative diseases. Brain Res Brain Res Rev 2005; 49: 633-640
4. Vyryt O, Altynda? A, Selek S, Yumru M, Bulut M, Erel O, Sava? HA, Herken H. Increased plasma ceruloplasmin levels in schizophrenia. Bulletin Of Clinical Psychopharmacology 2008; 18: 282-287
5. Bekaro?lu M, Bilici M, De?er O, Karaman SC, Örem A, Soylu C. Effect of Antidepressant Treatment on Acute Phase Protein Levels in Patients with Depression. Turkish Journal of Psychiatry 1997; 8: 260-265 Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S170